Research shines light on health-care inequalities for Black women

Black woman waiting office doctor

A new research report co-authored by Professor Agnès Berthelot-Raffard of York University’s Faculty of Health investigates the lack of evidence-based data for Black women’s health care in Canada.

Agnès Berthelot-Raffard
Agnès Berthelot-Raffard

Berthelot-Raffard, the principal investigator on “Santé gynécologique et obstétrique des femme noires : leurs expériences dans the système de santé québécois” (Gynecological and obstetric health of black women: their experiences in the Quebec health system), launched the report on Nov. 17 with co-authors Samia Dumais and Alexandra Pierre, both of Concordia University.

The report is now available through the Bibliothèque Nationale du Québec.

The novel study was funded by the Université du Québec à Montréal and aims to fill an important research gap in health-care equity in Canada. The research was done in a by-and-for methodology that centres on the needs and perspectives of the target community, says Berthelot-Raffard. It focuses on the reproductive rights of Black women in Canada.

Including testimonies gathered from Black professionals and patients, the report provides an analysis of the overall experience of Black women within the gynecological and obstetric health-care system, particularly regarding maternity, endometriosis and uterine fibroids.

Agnes Berthelot-Raffard co-authors and members of her research team, Samia Dumais (middle) and Alexandra Pierre (right), both of Concordia University
Agnès Berthelot-Raffard (left) with co-authors and members of her research team, Samia Dumais (middle) and Alexandra Pierre (right), both of Concordia University.

Started in 2020 in collaboration with Relais-Femmes, a feminist organization in Quebec, the study addresses a 2018 United Nations report that highlights the health disparities and limited health-care access faced by Black and Afro-descendant women compared to other Canadian population groups.

Research from the U.S., Canada and France indicates that Black women encounter differing perceptions and treatment in gynecologic and obstetrical care compared to non-Black women, says Berthelot-Raffard. Access to health care and adequate gynecological and obstetrical treatments for Black women is significantly influenced by stereotypes regarding the Black women’s embodiment, racial biases, social status discrimination, ageism and ableism, social and racial inequalities, geographic disparities, limited insurance or public care access due to citizenship status etc.

“These disparities lead to significant consequences, ranging from misdiagnosis, delayed care, limited access to information for informed decision-making, to mental health issues such as depression,” says Berthelot-Raffard. “Black women face increased risks during childbirth due to more caesarean deliveries than other groups of women, more late diagnosis of breast cancer, fibroids, endometriosis and higher rates of postpartum depression. In evaluating the quality of care during pregnancy and postpartum, women emphasize the importance of feeling welcomed within the health-care system alongside their physical well-being.”

The researchers will disseminate the study to various audiences, including health-care professionals such as doctors, obstetricians, nurses and students in health sciences and medicine, as well as with ethicists and occupational orders. The goal is to open the discussion in fertility clinics, birthing centres, abortion centres and feminist organizations as part of a campaign to raise awareness about these critical issues for reproductive justice and equity in the health-care setting.

“We’ve uncovered instances of obstetric and gynecological violence, including forced consent, disregarding their agency, physical abuse, verbal microaggressions and indifference from health-care professionals,” says Berthelot-Raffard. “Our analysis suggests that Black women in Quebec are more exposed to overmedicalization and medical negligence, indicative of discriminatory and abusive practices rooted in health-care stereotypes. This report marks a starting point in acknowledging obstetric and gynecological violence experienced by Black women in the Quebec health-care system.”