According to Dr. Cassandra Dixon, professor emeritus at University of Michigan Medical School,

African American women are four times more likely to die during pregnancy, childbirth, and the year immediately following, than White women.

This is despite the fact that America reportedly spends $111 billion a year—more than than any other country—on maternal health care. Yet in some regions of Mississippi, the maternal death rate for Black women exceeds that of some Sub-Saharan Africa, while the rate for White women in that state barely rates a mention. Dixon believes those statistics are the reason most physicians are quick to perform cesarean section surgery births when the expectant mother is Black.

“In addition to maternal deaths, the infant mortality rate for African American babies is more than double that of white infants,” Dixon said.

According to a recent report from the Centers for Disease Control and Prevention (CDC), college-educated Black women have birth outcomes that are worse than White women who haven’t finished high school.

Evelyn Kincaid, a medical statistician for the CDC, said medical researchers believe increased use of procedures on pregnant Black women to manage labor and delivery (e.g. labor inducing methods) could be the problem. Other researchers point to racism and stress that Black women are exposed to on a daily basis causing anxiety and the release of stress hormones that can trigger premature labor. Obesity could play a factor, lack of education, lack of access to quality health care services, and physician practice patterns. Not to mention some physicians may do a c-section to accommodate their vacation schedule.

Another issue Kincaid believes may be in the hair products. She referred to a five-year study that identified several Black hair products that contain toxic and possibly dangerous chemicals. “Those products could cause  Black women have rates of infant death 2.2 times higher than white women,” she explained.

Stress, racism could play role

Both Dixon and Kincaid agree that Black women have the highest cesarean rate of any other group, putting them at a higher risk of infection, hysterectomy, hemorrhaging, lower breastfeeding rates, longer post pregnancy healing time, more future C-sections, and even death.

There is a history of C-sections performed on the indigenous women of Africa. Traced to 1870, research has revealed that the women is administered a natural anesthetic developed from local medicinal plants. The exact process of cutting open the abdomen and moving into the uterus with a very sharp instrument involving one pass of the instrument to get to the child. The child is then removed from the womb and a midwife applies pressure to the abdomen to control blood flow and allow removal of the placenta. Sutures are applied to the outside of the abdomen.  An all-natural surgical topical solution is applied to the surface of the abdomen. The patient is then placed on her stomach (the repositioning of the patient reported allowed her body weight to assist in the draining process). With in two weeks, the wound was healed and the patient was released.

According to Dr. Katherine Bankole-Medina, the above cesarean section took place in the late 1870’s in  Central Africa. Reports of C sections being performed by a male however usually females performed the procedure.

During the procedure, highly polished iron needles and surgical thread (derived from tree bark) was utilized while an oral anesthetic and topical solution were made from botanical herbs

“So far as I know, Uganda is the only country in Central Africa where abdominal section is practiced with the hope of saving both mother and child,” Bankole-Medina wrote in a medical journal. “The operation is performed by men, and is sometimes successful. At any rate, one case in 1879 in Kahura came under my observation. The patient was a fine healthy-looking young woman of about 20 years of age. This was her first pregnancy. The woman lay upon an inclined bed, the head of which was placed against the side of the hut. She was liberally supplied with banana wine, and was in a state of semi-intoxication.

Rare glimpse at ancient practices

“She was perfectly naked. A band of mbuga or bark cloth fastened her thorax to the bed, another band of cloth fastened down her thighs, and a man held her ankles. Another man, standing on her right side, steadied her abdomen. The operator stood, as I entered the hut, on her left side, holding his knife aloft with his right hand, and muttering an incantation. This being done, he washed his hands and the patient’s abdomen, first with banana wine and then with water. Then, having uttered a shrill cry, which was taken up by a small crowd assembled outside the hut, he proceeded to make a rapid cut in the middle line, commencing a little above the pubes, and ending just below the umbilicus. The whole abdominal wall and part of the uterine wall were severed by this incision, and the liquor amnii escaped; a few bleeding-points in the abdominal wall were touched with a red-hot iron by an assistant.

“The operator next rapidly finished the incision in the uterine wall; his assistant held the abdominal walls apart with both hands, and as soon as the uterine wall was divided he hooked it up also with two fingers. The child was next rapidly removed, and given to another assistant after the cord had been cut, and then the operator, dropping his knife, seized the contracting uterus with both hands and gave it a squeeze or two. He next put his right hand into the uterine cavity through the incision, and with two or three fingers dilated the cervix uteri from within outwards. He then cleared the uterus of clots and the placenta, which had by this time become detached, removing it through the abdominal wound.

His assistant tried, but not very successfully, to prevent the escape of the intestines through the wound. The red-hot iron was next used to check some further hemorrhage from the abdominal wound, but I noticed that it was very sparingly applied. All this time, the chief “surgeon” was keeping up firm pressure on the uterus, which he continued to do till it was firmly contracted. No sutures were put into the uterine wall. The assistant who had held the abdominal walls now slipped his hands to each extremity of the wound, and a porous grass mat was placed over the wound and secured there. The bands which fastened the woman down were cut, and she was gently turned to the edge of the bed, and then over into the arms of assistants, so that the fluid in the abdominal cavity could drain away on to the floor.

The role of acupressure needles

“She was then replaced in her former position, and the mat having been removed, the edges of the wound, (i.e. the peritoneum), were brought into close apposition, seven thin iron spikes, well polished, like acupressure needles, being used for the purpose, and fastened by string made from bark cloth. A paste prepared by chewing two different roots and spitting the pulp into a bowl was then thickly plastered over the wound. A banana leaf warmed over the fire being placed on the top of that, and, finally, a firm bandage of mbugu cloth completed the operation.

“Until the pins were placed in position the patient had uttered no cry, and an hour after the operation she appeared to be quite comfortable. Her temperature, as far as I know, never rose above 99.6°F, except on the second night after the operation, when it was 101o F, her pulse being 108.The child was placed to the breast two hours after the operation, but for 10 days the woman had a very scanty supply of milk, and the child was mostly suckled by a friend. The wound was dressed on the third morning, and one pin was then removed. Three more were removed on the fifth day, and the rest on the sixth.

“At each dressing fresh pulp was applied, and a little pus which had formed was removed by a sponge formed of pulp. A firm bandage was applied after each dressing. Eleven days after the operation, the wound was entirely healed, and the woman seemed quite comfortable. The uterine discharge was healthy. This was all I saw of the case, as I left on the eleventh day. The child had a slight wound on the right shoulder; this was dressed with pulp, and healed in four days.”