What History Owes Black Women in Healthcare — and Why Trust Is Still a Medical Issue

When Black women express hesitation about the healthcare system — about providers, hospitals, clinical trials, or medical advice — that hesitation is not ignorance. It is not a cultural quirk. It is not a barrier to be overcome with a better brochure.

It is a rational, evidence-based response to a documented history of harm.

Understanding that history is not optional for anyone who wants to improve health outcomes for Black women. It is the starting point.

The man widely credited as the "father of modern gynecology" — J. Marion Sims — built his surgical techniques in the 1840s by operating repeatedly on enslaved Black women without anesthesia.

Sims performed dozens of experimental surgeries on at least three enslaved women — Anarcha, Betsey, and Lucy — to develop a repair technique for vesico-vaginal fistulas, a painful and debilitating condition caused by prolonged obstructed labor. He operated on Anarcha alone 30 times.

He did not use anesthesia. The prevailing medical belief of the era — a belief Sims himself held — was that Black people felt less pain than white people. This was not science. It was racism codified as medicine.

The techniques Sims developed on these women's bodies — without their meaningful consent, without pain relief, and without any benefit to themselves — became the foundation of modern gynecological surgery. His statue stood in Central Park in New York City until 2018, when it was removed following sustained advocacy from Black women's health organizations.

Anarcha, Betsey, and Lucy have no statues. Most Americans have never heard their names.

The belief that Black people feel less pain did not die with the 19th century. It survived — and it still shapes clinical care.

A 2016 study published in the Proceedings of the National Academy of Sciences surveyed medical students and residents and found that half of white medical trainees endorsed at least one false belief about biological differences between Black and white patients — including the belief that Black people have thicker skin or less sensitive nerve endings.

Trainees who held these false beliefs were less likely to recommend adequate pain treatment for Black patients.

This is not ancient history. These are physicians practicing today.

For Black women specifically, the consequences are direct:

• Black women are more likely to have their pain dismissed during labor and delivery
• Black women are less likely to receive epidurals when requested
• Black women are more likely to be discharged early after delivery, missing the window to catch postpartum complications
• Black women who report warning signs of preeclampsia or postpartum hemorrhage are more likely to be told they are overreacting

Serena Williams — one of the most famous athletes in the world, with access to the best medical care money can buy — nearly died after childbirth in 2017 because nurses initially dismissed her concerns about a pulmonary embolism. She had to demand a CT scan. She was right.

If it can happen to Serena Williams, it can happen to anyone.

The statistics have not meaningfully improved.

According to the most recent CDC Maternal Mortality Surveillance data:

• Black women die from pregnancy-related causes at 2.6 times the rate of white women
• The disparity is widest for women ages 25–39 — the peak childbearing years
• Over 80% of pregnancy-related deaths are preventable, according to state maternal mortality review committees
• Black women are more likely to give birth in hospitals with lower quality ratings — not by choice, but because of residential segregation and insurance coverage gaps

The United States remains the only high-income country where maternal mortality is rising. And within that rising number, Black women bear a disproportionate share of the burden.

Healthcare systems often frame Black women's distrust of medicine as a problem to be solved through better outreach, more diverse brochures, or community education campaigns. This framing gets it backwards.

Distrust is not the disease. It is a symptom of the disease — which is a healthcare system that has repeatedly failed Black women.

When Black women delay seeking prenatal care, avoid certain providers, or decline specific interventions, they are often making rational decisions based on lived experience and community knowledge. The solution is not to convince Black women to trust a system that has not yet earned that trust. The solution is to build a system worthy of it.

That means:

• Diversifying the physician workforce. Research shows Black patients have measurably better outcomes when treated by Black physicians. Black doctors represent approximately 5% of the U.S. physician workforce. That gap is not accidental — it is the product of decades of exclusion from medical schools and professional networks.
• Eliminating the pain bias from medical training. Every medical school curriculum should include explicit instruction on the history of race in medicine and the documented persistence of pain bias in clinical settings.
• Expanding doula access. Continuous labor support from a doula is one of the most evidence-backed interventions for improving maternal outcomes. Several states now cover doula services through Medicaid. Texas expanded this coverage in 2026. Every state should follow.
• Listening. When a Black woman tells you something is wrong, believe her. The evidence says she is more likely to be right than to be overreacting.

DaisyMe Foundation was built on the understanding that health equity requires confronting history honestly. Our community health navigation programs equip Black women with the knowledge, language, and advocacy tools to navigate a system that was not built with them in mind — while we work alongside partners to change that system from the inside.

Our maternal health programs include:

• Self-advocacy training — knowing your rights, knowing the warning signs, and knowing how to be heard
• Doula connection services — helping community members access doula support, including Medicaid-covered options
• Provider accountability resources — tools for evaluating providers and reporting dismissive or discriminatory care
• Community education on the history of race in medicine, because informed patients are safer patients

Anarcha, Betsey, and Lucy were not footnotes. They were women. Their suffering built a medical specialty that has saved millions of lives — and they received nothing for it. Not credit. Not care. Not even their names in the history books until advocates fought to put them there.

The least we can do — the absolute minimum — is build a healthcare system that sees Black women fully, treats their pain seriously, and earns the trust that history has made so difficult to give.

That work is not finished. DaisyMe Foundation is committed to it.

Sources: Owens, D.C. (2017). Medical Bondage: Race, Gender, and the Origins of American Gynecology. University of Georgia Press. | Hoffman, K.M. et al. (2016). Racial bias in pain assessment and treatment recommendations. PNAS. | CDC Maternal Mortality Surveillance System, 2023 data release. | ACOG Committee Opinion on Racial and Ethnic Disparities in Obstetric Outcomes, 2021.

This article is for educational purposes only and is not a substitute for medical advice. If you have concerns about your pregnancy or postpartum health, please contact your healthcare provider or call DaisyMe Foundation's community health line.