ARI SHAPIRO, HOST:
Black mothers in the U.S. die at three to four times the rate of white mothers according to the Centers for Disease Control and Prevention. Now, two recent high-profile stories have shown that serious complications in pregnancy and childbirth can even affect the most famous and successful black women. In the latest issue of Vogue, Beyonce reveals that she had an emergency C-section when she gave birth to twins last year. And earlier this year, tennis star Serena Williams shared her own harrowing account of an emergency C-section and the complications that followed.
Dr. Valerie Montgomery Rice is president and dean of Morehouse School of Medicine in Atlanta. She's also trained in obstetrics and gynecology. Welcome to the program.
VALERIE MONTGOMERY RICE: Hi, how are you doing?
SHAPIRO: I'm fine, thanks. How do the complications that Beyonce and Serena Williams had during their pregnancies illustrate the experience of black mothers during pregnancy and childbirth?
MONTGOMERY RICE: Well, one of the things that we know is that first of all, pregnancy is not without its complications. We know that when we look and see that - African-American women compared to Caucasian women, we know that they have a higher rate of having preterm birth. And they also have a higher rate of having any other complications of pregnancy that will cause them to have a higher mortality rate.
SHAPIRO: And what's the reason for those complications being so much more common among African-American women than white women?
MONTGOMERY RICE: We know that when we look at the issues that have plagued black women for many, many years, they have a higher risk of diabetes. They have a higher risk of obesity coming into pregnancy. But we also have now begun to see that they come in with a higher profile of stress and other issues that have complicated their baseline. We tend to call it microaggressions and other things that may increase their stress profile in general.
SHAPIRO: Are you saying that the actual experience of bias and discrimination in daily life is enough to affect a woman's health?
MONTGOMERY RICE: For sure. We clearly can see that when you start to interview these women, they can tell you of repeated insults that they have that raise their stress level. We've asked - and I'm pushing more research in this area to understand physiologically why that leads to some of the increased complications that we're seeing. But we do know also that when we control for socioeconomic factors such as access, when we control for factors such as no issues of diabetes or high blood pressure before pregnancy, comparing them to white women, we still see the higher rate of complications.
SHAPIRO: To see African-American women who have every resource at their disposal still run into problems really seems to suggest that there is something fundamental about the experience of African-American women no matter what their socioeconomic status and medical background might be.
MONTGOMERY RICE: I mean, I think you hit the nail on the head. Fortunately, people like Ms. Beyonce and Ms. Serena Williams had enough fortitude and access to be able to address their issues. But there are a lot of women who unfortunately did not have someone to speak for them and could not speak well enough for themselves. And they are left - their child is left for somebody else to take care of.
SHAPIRO: That's Dr. Valerie Montgomery Rice, president and dean of Morehouse School of Medicine in Atlanta. Dr. Montgomery Rice, thank you for joining us.
MONTGOMERY RICE: Thank you. Transcript provided by NPR, Copyright NPR.