Dr. Larissa Cassiano is a gynecologist that specializes in high-risk pregnancies
Note from BBT: It’s another topic that black Brazilians, specifically black women, have long exposed as a number example of being black in a decidedly anti-black country such as Brazil: receiving medical services, particularly when in need of an obstetrician or gynecologist.
The complaints of medical treatment have existed for years. Black people have complained of how doctors in Brazil seem to treat them as somewhat of a serial number rather than people. My experiences with this were simply something that I read about online until I saw the situation up close with my girlfriend at the time.
After having returned to a hospital after experiencing postpartum pain and discomfort, I was appalled with the manner in which medical receptionist spoke to her when she was describing how she was feeling. Her attitude was very curt, borderline rude, as if she just didn’t care about the symptoms. How do you speak to someone who just had a baby and is in clear pain in such a manner? If was as if we were interrupting her day, or in that case, night.
But that wasn’t the only experience.
On other visits to clinics and hospitals, I noticed how doctors hardly even looked at my girlfriend or the kids or interacting with them as they checked vitals, asked questions or had to touch them in some way. After asking brief questions and making an assessment, it was like, ‘fill the prescription and take it every six hours. Who’s next?’ I remember after one visit, we both looked at each other like, ‘did you see that?’
Like I said, I’d read about this sort of treatment for years, but it’s always more striking when it happens to you personally. Of course, the medical industry will downplay such reports, especially when people bring in the race issue. But it’s like, when you hear black woman after black woman complaining of such treatment, how long do you dismiss it?
When you do research, you find that the experiences of 42-year-old Michele Monteiro are pretty common. Monteiro had already had four children and pregnant with her fifth, she suffered in pain for 14 hours until receiving authorization to have a c-section. Michele had a heart murmur and was diagnosed with high blood pressure, which classified her fifth pregnancy as high risk.
Michele said that, because of the difficulties she experienced with her first four children, she didn’t want a normal delivery. Begging for a c-section and anesthesia, Michele said she had reached her body’s limit of pain when she heard the following: “But how? You have had four children, two normal, two forceps. Why don’t you try one more? You are strong, you can handle it.’’
Michele is a black woman, and as such, she was susceptible to being treated according to well-known stereotypes that “Black women have wider hips and are therefore ‘parideiras’ par excellence,” “black women are strong and more resistant to pain.” Parideira is a term used to describe women who are considered very fertile and already have more than a few children. Even though these beliefs about black women have no scientific basis, they are widespread among many Brazil’s medical establishment. (see note one)
With such ideas, and the rise of black consciousness in Brazil, it’s not by chance that many black people feel a sense of comfort or relief when they know they will be cared for by black doctors. It’s still not a common experience as black people are still vastly under-represented in the medical field, but the numbers are growing, which will no doubt increase more pleasant experiences such as one shared in the story below by Larissa Carvalho.
The day I was seen by a black gynecologist for the first time
By Larissa Carvalho
Monday, May 17, was supposed to be just another normal day of a trip to the gynecologist, but it turned out not to be. Not really. When I arrived at the clinic, I was waiting to be called to enter the office. I saw a doctor with curly hair passing by in the hallway. At first, I couldn’t see her face, because of the mask. It was a quick moment. But I thought: “Could this be the doctor who will see me? No, it’s not possible!”.
When she came back to the office, my name was called on the monitor. So, I went in and entered the room and was able to confirm. I was being seen for the first time in my life by a black gynecologist! A black woman with light skin and curly hair like me. Suddenly, I saw myself there… I recognized myself. Still not believing it, but already believing it, I said: “I can’t believe she is a black doctor! In my health plan, I have only met one black doctor so far, and it was an African black man.
She smiled with her eyes, that’s what I could see being she was wearing a mask at that instant. “It’s hard to find, isn’t it? I was the only one in my medical school class…,” she said. At that moment, I remembered and also mentioned that I had been the only black woman in my Journalism class…so I was being seen by a black doctor.
Most women know that gynecological exams are a little invasive and, depending on the exam, can hurt a lot. But I needed to go. I needed to appreciate and take care of my health. The last time I had gone for such an exam had been in 2018. It was with a white doctor. It was one of the most horrible experiences with white gynecologists I have ever experienced. I was tense, she was impatient. And she hurt me…so I remember I left the office quite sore. I had a discomfort for a few days that later culminated in a vaginal candidiasis. I am not sure if there was a direct relationship, but the experience of the exam was horrible. I didn’t have the routine exam again for 2 years because of the trauma, and then because of the pandemic.
The fact is that, when we go looking for the list of doctors and physicians in the health plan or wherever to make an appointment, we hardly imagine that any of those names could be the name of a black person. A professional who will treat me well. A professional who will make a difference in my life. This hardly crosses our minds.
The doctor received me so well that I could talk, ask questions and feel welcome. No judgments, no impositions, no violence. There was much respect, much care and much welcoming. That’s how I felt: respected, cared for and welcomed. After all, I was at home. Because we, black women, know that being with each other is ancestral. It is being at home and being well taken care of… I can hardly describe here my feeling of having gone through this experience and having had the privilege of finding a black gynecologist in Fortaleza, Ceará. It was one of the best experiences I have had in my life.
As always, I was a little nervous at the moment of the exam and I was calmed down. It is impossible to describe the differential that it is, as a black patient, to be seen by a black doctor. Her patience and welcome made me feel that it wasn’t going to be a painful moment, like last time. But I was still tense.
“Last time it hurt a lot, and I was very sore”, I said with a bit of nervousness.
“But today it won’t hurt too much, don’t worry”, she said.
Then I calmed down and took a deep breath. Then I breathed lightly. I transferred my breathing to my pelvis, relaxed and got through it. It was different, because I didn’t feel hurt. It wasn’t violent. As many of us black women bring back stories and bad (and why not say traumatic) experiences with white female doctors and who end up being impatient (and why not also say violent!).
It’s amazing, as talking to some irmãs negras (black sisters), I also heard similar accounts to mine of traumatic experiences. My belief is that many (non-black) professionals, who are in medicine, don’t care for the black population the way we need them to. My happiness is that we are having many advances within our community and I have the possibility of being cared for by a black doctor. Even if in a “small” probability.
There is a myth that makes people believe that the black woman is more resistant to pain. And there is a study – ”Clinician-Patient Racial/Ethnic Concordance Influences Racial/Ethnic Minority Pain: Evidence from Simulated Clinical Interactions” – published in August of last year that says that black patients when seen by black doctors feel less pain. One of the authors of the research, Elizabeth Losin, found that black patients reported that they feel less discomfort during interventions when seen by black doctors than when receiving procedures from white or Hispanic doctors.
When I saw someone commenting on Twitter about this study done in the United States, I thought yes, it is very possible. It is possible to be seen by a black doctor and feel less pain during an invasive exam. It’s possible to be treated well and feel cared for. It’s possible to look to the near future (since I want to be a mother soon) and be less afraid of obstetric violence. It’s possible! Because if there is a black professional on the team, I will feel well and welcome.
The black doctor who tended to me doesn’t even know it, but she made my day better. She made me believe (and remember) that I can be respected, welcomed, and well taken care of in a doctor’s office. Unfortunately, I couldn’t express this feeling at the time of the consultation to her. I just thanked her and was grateful for the “chance” for this discovery and valuable experience. And, by no means, I could keep this experience and this report to myself… I hope it will be the first of many.
Note: There are numerous articles in the archives about the issue of black Brazilians, particularly women, who have endured negligent medical treatment, often because of racial stereotypes. See here.