With conversations about the United States’ maternal health crisis comes an increasing awareness of racial disparities in maternal and infant health. A recent New York Times report reveals that the figures unveiling these disparate outcomes is one piece of a larger story of inequality within the maternal health sphere.
Hospitals are more likely to administer drug tests to Black birthing people than white birthing people, regardless of their history of substance use. Addressing these disparities requires more than the acknowledgement of the implicit bias that shapes the medical establishment’s engagement with Black birthing people. A major underpinning of this disparity lies within a charged historical moment seemingly unrelated to maternal health—our country’s war on drugs, and the concurrent push to criminalize Black people struggling with drug addiction.
On June 17, 1971, President Richard Nixon stood alongside his newly appointed Drug Authority to make an assertion regarding the state of the nation. He named drug abuse as America’s “public enemy number one”. Fighting this enemy required the employment of a new offensive strategy. He would designate funding towards supporting the battle—a battle that would be international in nature. It would be holistic, pulling together different sectors of the United States government. It would be national, resulting in the widespread release of an educational program. Congress would allocate over 150 million dollars towards his strategy.
While the issue of widespread drug use swept through different spheres of our nation—from the United States military in Vietnam, to low-income communities in inner cities—the media’s framing of the issue of drug use often differed with the race of victims. To understand the implications of these journalistic practices, we must first explore the context in which this framing occurs.
Whereas Nixon was said to employ a catch-all approach that called for the elimination of drug use across the nation, the discretion of policymakers and officeholders meant that personal preconceptions undoubtedly shaped the collective approach. While drug use was on the decline in the early 1980s, several campaigns began centering low-level drug dealers and street-level drug offenses, such as possession and trafficking. Coinciding with this shift was an increase in the arrest and imprisonment of low-income Black people. Whereas Black people made up 22% of drug-related arrests in 1976, this percentage nearly doubled to a whopping 41% by the late 1980s. White Americans experienced the opposite trend in arrests. Their percentage dropped from 77% in 1976, to 59% in the late 1980s. Usually, the closing of racial gaps warrants celebration. In this case, it calls for investigation.
Sensationalized media descriptions of America’s drug problem were particularly pernicious in their subtle demarcation of the Black community for investigation. With an increase in cocaine importation came the emergence of crack cocaine, a cheaper form of the drug that heightened the drug’s accessibility to low-income Black communities. In a Los Angeles Times article, a staff writer noted that crack addiction soared as illegal drug use dropped, a thought pattern which 1) contributed to widespread blame and the use of the bootstrap ideology within the context of addiction and 2) marked America’s Black communities for increased scrutiny.
Black motherhood wasn’t just a sphere of heightened scrutiny. It was ultimately a sphere of devaluation in the fight against drug addiction. The myth of the crack baby was born out of the ostensible concern for Black babies—a myth that our biomedical establishment legitimized. With this came the vilification of the “crack mother”—a dangerous figure who posed the greatest risk to her child. These widespread beliefs rendered drug testing invaluable, as it was the only way to confirm and stop prenatal exposure to crack cocaine.
Rather than using the visibility of the press to acknowledge and call for a reshaping of policies and societal conditions that caused low-income Black women to use crack at heightened rates, writers often used their platforms to vilify these mothers and promote eugenicist ideologies. In one Seattle newspaper, a journalist called for the punishment of mothers of “crack babies”. According to writer Bellevue Matthews, none of the proposed solutions appeared to work for these mothers, and so, the punishment that most aligned with the severity of the issue was preventing mothers from having ‘crack babies’ in the first place.
It is no surprise that decades later, we are observing heightened rates of drug testing among Black mothers—even in the absence of heightened rates of drug use. As the myth of the crack baby disappears, the anti-Blackness, misogynoir, and devaluation of Black motherhood in America is ever-present. It is not enough to discuss the contributions of bias and discrimination to interactions within the medical setting. We must dig deeper and acknowledge the charged, anti-Black history that underwrites the invasive and discriminatory practices disproportionately impacting Black mothers and birthing people.