Medical racism in the United States is not an accidental flaw in the healthcare system—it is a product of centuries of deliberate policy, practice, and ideology. From the earliest days of slavery, Black women’s bodies were sites of exploitation and experimentation, laying a foundation for modern obstetrics that continues to benefit from their suffering. Enslaved women were often subjected to surgical procedures without anesthesia, under the false and racist belief that Black people had a higher pain tolerance (Washington, 2023). These dehumanizing practices were not isolated, but rather embedded in the professionalization of American medicine, shaping how care is still delivered today.
In the 20th century, this legacy evolved into coerced sterilizations and reproductive restrictions disproportionately targeting Black, Indigenous, and poor women. These procedures, often carried out without full consent, were rationalized under eugenic ideologies that positioned marginalized women as unfit to reproduce (Taylor, 2020). In Canada, Indigenous women continued to be sterilized against their will as recently as the early 2000s—a practice now internationally recognized as a form of state violence (Webb, 2022). These historical violations are not distant memories; they cast long shadows across today’s clinical environments, shaping the fears and mistrust many women of color carry into medical settings.
That mistrust is not unwarranted. Today, the consequences of medical racism are visible in staggering disparities in maternal health. According to the CDC, Black women are more than three times as likely to die from pregnancy-related causes than white women—a rate that reached 50.3 deaths per 100,000 live births in 2023 (Hoyert, 2025). These are not statistical flukes; they are preventable deaths occurring in one of the world’s wealthiest nations, reflecting failures in care, delayed interventions, and a lack of culturally competent treatment.
The problem is compounded by underrepresentation in the medical workforce. After the 1910 Flexner Report shuttered most historically Black medical schools, a pipeline of Black physicians was effectively cut off. Today, only 15.3% of OB/GYN residents are from underrepresented groups in medicine, with Indigenous representation being especially scarce (Deville, 2024). This lack of racial concordance between patients and providers contributes to mistrust and poorer health outcomes. Studies show that patients of color tend to report better care experiences and higher adherence to treatment when treated by providers who share their racial or cultural background.
Moreover, racially biased diagnostic standards continue to disadvantage women of color. Black women are more likely to suffer from pregnancy-related anemia, yet are frequently underdiagnosed due to outdated ferritin thresholds that fail to account for the unique health challenges posed by systemic inequities (Tang & Sholzberg, 2024). These medical blind spots further illustrate that racism in healthcare is not just about interpersonal bias—it’s about structural neglect baked into how medicine is taught, practiced, and measured.
Understanding the roots of medical racism is the first step toward dismantling it. Without confronting these historical and present-day injustices, meaningful reform will remain out of reach—and more lives will continue to be lost to a system that was never designed with them in mind.
