Black mothers face scrutiny, distrust in pediatric health care
By Louise Kinross
Imagine your family is travelling on a medical bus with three other families from Canada to the United States, where your child is booked for surgery.
At the border, police pull your family off. You’re separated from your disabled child, and police check your dreadlocks and your child’s prosthesis for drugs. “I mean, there’s four families, we’re the only Black family—me, his father, and him are pulled off a surgery bus, which is obviously a medical bus.”
This is one example of anti-Black racism experienced by three Canadian mothers as they navigate health care for their children in a qualitative study published this month in the Journal of Childhood Studies. Fiona Moola, associate professor in the School of Early Childhood Studies at Toronto Metropolitan University, was lead author.
Ninety-minute interviews and the creation of portraits about their experiences revealed three types of injustices as the mothers sought care for their child: biological determinism, such as a hospital nurse explaining that a baby was “very dark-skinned” because the mother had “Black blood;” surveillance and control, which included a mother’s Black child receiving less pain medication than white children following surgery; and clinicians suggesting Black mothers were incompetent.
“…the centrality of the white disabled Eurocentric child is a symbolic violence that has erased the lives of other children, especially Black children and their families,” the authors write. "Qualitative studies on anti-Black racism in pediatrics are few and far between."
One mother in the study recounted a doctor who repeatedly questioned her description of her child and made her feel like “I didn’t know anything about autism. 'Are you sure you saw… him scratching at his tag,' the doctor asked. '… Are you sure his socks really bother him?'” “I’m not a specialist, but this is my child I see every day,” the mother said.
Another mother said that after her daughter had surgery at a Canadian hospital, the pediatrician scolded her choice of clothes. “It was very hot in the hospital, so I had a t-shirt [on]…” the mother said.
“Do you know it’s winter outside and it’s really cold, and you need to dress up?” the doctor said. “You have a daughter who’s going to have a lot of health appointments and you’re going to have to be really serious and focused about it.”
The mother thought: “Holy moly, what does she think?... Does she say that to every parent? I thought… she’d waited for that moment when I was going to be alone, when my husband was not there… as if she needed to ‘put some sense’ into me.”
Another mother noted that her Black son, who had just had painful limb lengthening surgery, was sent home with two bottles of morphine. By talking to other parents, she learned their white children received four bottles on discharge. “…My son…not giving him enough morphine. Like do you think we’re drug addicts? You think I’m trying to sell his morphine on the streets?”
The authors refer to these incidents as examples of epistemic injustice because the voices and experiences of Black mothers are silenced.
Children’s health systems “must take responsibility for perpetuating anti-Black racism and upholding white supremacy,” the authors say. Recommendations include public apologies, clinician education about how racist assumptions and microaggressions traumatize families, and finding new ways to engage Black families that honour their wisdom.
"Anti-racist and culturally safe research approaches, such as Black feminism and arts-based and decolonizing research, are ethical and sensitive frameworks that reduce the risk of further harm to Black families," Moola says.
Co-authors on the study were Kathia Johnson and Nivatha Moothathamby. All are racialized.
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