Birth Disparities in Durham

What was Gained and Lost after Desegregation

GAINS AND LOSSES

Lincoln was more than a hospital: it was a deeply loved community institution. After desegregation, Black Durhamites experienced a loss of community support and relationships with care providers as maternal and infant care moved from Lincoln to other hospitals.

“Black patients wanted to go to Lincoln. They wanted to go to Lincoln because they knew they’d be treated with respect, dignity… “

– Dr. Charles Harris, OB/GYN

²⁴ P. Preston Reynolds, Durham’s Lincoln Hospital

²⁵ North Carolina State Board of Health

As formerly segregated hospitals opened to Black patients, they gained access to specialized, well-resourced facilities formerly reserved for white people. These resources slowly improved rates of infant loss, maternal death, and infection among Black obstetrics patients.

Though maternal health outcomes for Black Durhamites improved after desegregation, disparities between white and Black maternal health and neonatal death rates persisted.

Today, Black mothers often describe feeling disempowered during their interactions with providers, whom ignore their concerns and symptoms. These interactions are both unpleasant and contribute to the disparity between Black and white maternal health outcomes.

²⁶ Edgemont Community Clinic Records, 1968-1979

“When she questioned the incorrect dose of anesthesia…one nurse said, ‘You ask a lot of questions, don’t you?’ and winked at another nurse in the room and then rolled her eyes.”

In a 2018 New York Times story by Linda Villarosa, Simone Landrum described her recent experience with untreated pre-eclampsia in New Orleans.

²⁷ New York Times

Black maternity patients are less likely to receive pain relief, but more likely to experience severe pre-eclampsia, postpartum hemorrhage, and premature labor. Recent studies suggest that failure to take Black women’s symptoms, questions, and requests seriously contributes to these disparities. Today, some women are able to employ doulas to serve as both support coaches and advocates to be sure their voices are heard. Lincoln hospital’s trusted nurses may well have served a similar purpose over 50 years ago. Desegregation ultimately brought better medical resources, but at the cost of the loss of a trusted institution.

²⁸ Proceedings of the National Academy of Sciences