The Hidden Health Inequality Facing Even the Wealthiest Black Mothers

You may recall Khiara Bridges from That Video—the one from July 2022, where she calls Missouri Senator Josh Hawley “transphobic” to his face. As one of the leading scholars in the country on race and reproductive justice, the UC Berkeley law professor was testifying before Congress about the harms of the Dobbs decision overturning Roe v. Wade, including to Black maternal health. As she often does in her writing and conversation, she used gender-neutral language—“pregnant people” and “people with the capacity for pregnancy.” The ultraconservative Hawley, predictably, pounced, repeatedly emphasizing the “people” part and demanding, “Would that be women?”

“I saw that coming from a mile away,” Bridges tells me almost four years later, having witnessed the similar goading that future Justice Ketanji Brown Jackson received from a different Republican senator during her Supreme Court confirmation hearings. “I remember watching the hearing and thinking, she can’t really speak because she needs something.”

One reason the resulting 1:40-minute exchange went viral was that it had something for both sides: Bridges comes across as earnest and nervous and, yes, “woke”—a conservative’s caricature of a progressive, Black, female attorney. Hawley epitomizes liberal stereotypes about MAGA lawmakers as smirking, cynical, cruel, and determined to ignore and demean modern realities. Some time later, one of Bridges’s students sent her a thank-you note: The video had landed in his Twitter feed on the anniversary of the suicide of his sister, who’d been trans. “The erasure of trans individuals [is] such an incredible injustice,” she tells me. “I didn’t want to hide the fact that I think that trans people exist.”

Examining the structures that lead to injustice and erasure has been a central theme of Bridges’s scholarship for two decades. As a freshly minted Columbia Law grad in the early 2000s, she decided to pursue a PhD in anthropology. “I was interested in how law produces culture,” she says, “and how culture, in turn, produces the law.” Her dissertation became her first book, Reproducing Race: An Ethnography of Pregnancy as a Site of Racialization (2011), an influential study set in a publicly funded hospital in New York City. She has also written extensively about critical race theory and the relationship between privacy rights and class.

Now Bridges has published her fourth book, one that feels very much like a sequel to her first: Expecting Inequity: How the Maternal Health Crisis Affects Even the Wealthiest Black Americans. In it, she tries to answer a question that has perplexed researchers—and journalists like me—for at least a decade: Why don’t education and income protect Black women from disproportionately high rates of maternal mortality and life-threatening complications? The book focuses on San Francisco, which has one of the widest income gaps in the US and a Black population so small that encountering a Black woman with private insurance “was like seeing a mythical creature,” Bridges says. But her two years of research, including 200 interviews, deepened her understanding of the entire US maternal care system. “The healthcare segregation here,” she says, “looks a whole bunch like the healthcare segregation in New York City, in Chicago, in Atlanta, in Miami.”

Her anthropologist’s perspective isn’t the only thing that distinguishes Bridges from other legal scholars. A dancer since she was 3 years old, she performed professionally at small but prestigious ballet companies in New York City while earning her law and anthropology degrees. The double life continued after she started teaching at Boston University School of Law—on weekends, she commuted to New York to perform. She moved to UC Berkeley almost seven years ago, and though she no longer dances professionally, she works out with local ballet companies almost every day.

The afternoon of our chat, fresh from teaching a class, she greeted me wearing a pair of impossibly high-heeled black Louboutins and dangly hoop earrings the size of small tires. Her hair was swept into a ballerina-esque topknot, and her nails were impeccably manicured in lavender and black, the colors of her book jacket. The message to her students is subtle but empowering: They don’t have to erase themselves, either. As she tells me, “You just gotta do you.”

Our conversation has been edited for length and clarity.

How did you decide to turn your anthropological lens on reproduction and pregnancy?

My uncle, James Bridges, was one of the first Black board-certified OB-GYNs in Miami. He’s such a larger-than-life figure in the family. My interest in pregnancy began because he had made pregnancy his area of expertise.

But in law school in the late 1990s and early 2000s, “reproduction” meant “abortion.” There was not much [legal] scholarship about the intention and desire to carry a pregnancy to term. Family law has always had its place in law schools, but not maternal health. When I decided to pursue a PhD after law school, I thought that my dissertation project would be about abortion. Then the institutional review board at Columbia told me: “Not so fast.”

These boards exist to ensure that researchers do........

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