Maternal Health

DISPARITIES AND DESEGREGATION IN DURHAM, 1960-1980

Durham was a tumultuous place in the 1960s. The Civil Rights Movement was in full swing as Black Durhamites fought for equal rights and the end of Jim Crow. Just as for schools, restaurants, and transportation, desegregation of hospitals had the potential to equalize long-standing inequities and reduce health disparities. Yet the promise of better resources was undermined by the loss of a trusted environment, that of Lincoln Hospital. The consequences of desegregation for Black women were complex and conflicting.

The birth of a child can be an incredible moment, yet too often it was marked with loss instead. In Civil Rights era Durham, Black mothers and babies had higher rates of pregnancy and birth-related morbidity and mortality than their white counterparts. What caused these racial disparities in maternal and child health? How did desegregation change African-American women’s childbirth experiences?

¹⁶ P. Preston Reynolds, Durham’s Lincoln Hospital

¹⁷ Delivery Book, Duke University Medical Center Archives

Duke Hospital’s delivery books from this period contain records that exemplify racial disparities in birth outcomes.

A HUGE CHASM

A survey of 1,190 births at Duke Hospital between 1960 and 1964, revealed that Black women were more likely to have low-weight babies than white women. Low birth weight is closely associated with neonatal death and future chronic health problems. Black maternity patients at Duke were also significantly more likely than their white counterparts to experience pre-eclampsia, a potentially fatal pregnancy complication, and more likely to experience pregnancy loss.

TWO HOSPITALS, TWO DURHAMS

In 1960, most Black women in Durham gave birth in one of two hospitals. Lincoln Hospital opened its doors in 1901 as an alternative to whites-only Watts Hospital. Founded by Durham’s first Black physician, Dr. Aaron Moore, Lincoln gained a national reputation for excellence thanks to support from Durham’s African-American community and the Duke Endowment. Though the hospital building was showing signs of wear by the 1960s, it continued to care for the city’s black residents regardless of their ability to pay.

¹⁸ P. Preston Reynolds, Durham’s Lincoln Hospital

“Lincoln in its heyday was basically a powerhouse.”

-Dr. Charles Harris, OB/GYN

Duke Hospital treated patients of both races on segregated wards from its opening in 1930. Black women in Durham often delivered at Duke because of medical complications during pregnancy. In the 1960s, while white women might deliver in private rooms or the public ward, black women were on a single ward that could be curtained off for private patients.

¹⁹ Baker House – OB/GYN clinics, Duke University Medical Center Archives

“The [Duke] facilities were large wards that were separated by curtains rather than individual or even semi-private rooms. And there was no air conditioning. So it was a long summer.”

-Dr. Charles Hammond, OB/GYN