In June of 2022, beauty influencer Jessica Pettway experienced what she called “intense vaginal bleeding”. Concerned, she looked to her peers to confirm that her bleeding was normal. Among the associated symptoms were fatigue, weakness, and a general sense of not feeling like herself.
The next month, Pettway’s husband would find her unresponsive on the bathroom floor. She was rushed to the emergency department, and the visit ended with physicians notifying her that uterine fibroids were the cause of the vaginal bleeding that almost took her life. Her gynecologist would repeatedly assure her that her symptoms were normal, and so, despite her growing anxiety, Pettway did what most people would, and trusted the word of the medical professionals.
A few short weeks after, Pettway would be hospitalized again, and the medical professionals in the room remained married to her initial diagnosis. They would treat her condition as, in her own words, “just” fibroids.
While the bleeding eventually stopped, labor-like pains would take their place. In January of 2023, Pettway spent a week in the hospital, where her care team informed her that she could not get surgery to remove her fibroid because of her limited blood supply. After doing a biopsy, an oncologist informed Pettway that she had stage three cervical cancer. The diagnosis of fibroids had ultimately been false. Sadly, Pettway recently succumbed to the illness and passed on March 11th at the age of 36.
A number of circumstances surrounding Jessica Pettway’s passing render the situation uniquely devastating and bizarre. When something felt off, she went to the hospital, only to be met with an air of dismissal about her worsening symptoms. As things got worse, she trusted her knowledge of her body and went back to the hospital, only for medical professionals to insist that she, once again, was experiencing normal symptoms.
When Black women are lost to premature and preventable death, well-meaning advocates often underscore the warning signs of the named condition and encourage people to act before it is too late. However, the experiences of Jessica Pettway and numerous other Black women lost to the hands of our healthcare system signals that even well-meaning investigators are not asking the right questions.
The discourse surrounding preventive measures inadvertently masks a sinister reality about the state of United States healthcare. Jessica Pettway’s tragic passing is a reminder that Black women and femmes are not safe under current conditions of care, even as we do “right” by standards of optimal care and prevention.
Not only is the timing of Pettway’s cervical cancer diagnosis a reality that disproportionately impacts Black women, but the story that led to her untimely death is one that mirrors those of many Black women in the United States.
Although Black women and white women receive diagnoses at similar rates, Black women are more likely to die of cervical cancer. What’s worse, Black women have the highest mortality rate of any other racial group. Evidently, there are care gaps, and these gaps unveil the pernicious effects of structural racism on Black women’s livelihoods and bodies. For this reason, we must couple our efforts at communicating warning signs and symptoms with a thorough evaluation of the manifestations of structural racism within the context of Black women’s care.
Structural racism can present as unconscious bias in gynecological care, which tends to be an extension of societal preconceptions about Black womanhood. Physicians have great discretion in their recommendation of cervical cancer screening—a level of agency that can prove fatal for Black women and birthing people. Notions of Black women’s exceptional strength and imperviousness to pain, or an unconscious disregard for our suffering, may lead physicians to 1) dismiss the complaints of Black women and 2) stall on recommending a patient for screening. Because the efficacy of treatment correlates with the speed of detection, time is of the essence.
Another manifestation of structural racism within the medical establishment is the systematic erasure of Black women and birthing people. When key stakeholders make important decisions regarding the standard of care, Black women are again reminded that they are not among the populations whose needs are readily considered, let alone anticipated. Despite growing knowledge of the significance of screening and early detection, nascent policy decisions have done away with annual pap smears. The reason for this change seems scientifically sound. According to health professionals, the expansion of time between the screening tests is an acknowledgment of the amount of time it takes for cervical cancer to develop.
While health professionals are deeming annual pap smears unnecessary, the current state of Black women’s cervical health renders routine screening indispensable in the effort to reduce mortality. Jessica Pettway’s presentation at the time of diagnosis not only offers clues about her premature passing, but also reflects a devastating trend. Black women are more likely to present with advanced cervical cancer, which undoubtedly contributes to the high rates of mortality. Even in the absence of interpersonal experiences, these policy decisions manage to undermine Black women and birthing people to reproduce negative health outcomes.
Behind Jessica Pettway’s passing is a cocktail of noxious conditions for Black women in the United States. Equally as critical as working towards a solution is asking the right questions and taking care, and action. Without constant evaluation and analysis of the circumstances conducive to devastating outcomes, the United States’ medical establishment will continue to needlessly fail Black women.
