Health Equity

I Didn’t Realize How Badly I Needed To See A Black Fetal Illustration Until I Finally Did

In moments like this, we are grateful for a powerful shift in the status quo, but also saddened that it is such a phenomenon.

Chidiebere Ibe is a Nigerian medical student who was unsettled noticing that there were no illustrations of Black people in his medical books, so he created his own and shared them on Twitter. The immediate response was a collective pause in awe across social media — because we’re wondering why this has been missing for so long and why the lack hasn’t already been confronted. As a Black mother, one particular image made my breath catch: A Black baby in utero.

Just a few years ago I found myself almost 75 pounds over my normal weight, pregnant with twins, and in and out of the hospital for one reason or another. I had to see a specialist; I was a part of a parents-of-multiples group headed by a labor and delivery nurse; I participated in every single parenting boot camp and educational class available in our area — if they offered it, I signed up.

During all of this, not once did I see a poster, image, anatomy figurine, or pamphlet depicting a Black baby in utero. When I requested an additional doll for my “baby bootcamp” (since I needed to get used to holding two newborns!), I didn’t waste my time asking for Black dolls because I already knew the answer. There wasn’t much diversity in the pile of white practice babies.

What I’m realizing though, is that these racist norms dually program us — Black people — to accept exclusion, or else these images wouldn’t have hit us so hard.

Ibe’s illustrations, which he tags with “diversity in medical illustration,” are such a phenomenon because you don’t realize you’ve never seen it until you actually see it.

After reeling in my amazement, I realized how badly I needed this to exist in the world: the representation and normalization of Black bodies in medicine.

While some may debate the effects of systemic and implicit racism in our health care system, countless studies have proven it’s real. These biases exist and thereby affect how minority patients are treated. What I’m realizing though, is that these racist norms dually program us — Black people — to accept exclusion, or else these images wouldn’t have hit us so hard.

I wonder how much more reassured I might have felt if I had seen any evidence that the medical community centered and valued my body, the bodies of my growing children.

When I was pregnant, I was working just as hard as any mother to be educated about birth, parenting, and what to expect. And honestly I was scared! Parenting for the first time and to twins. Not having any guidance or information that looked like me shouldn’t have been an issue. I wonder how much more reassured I might have felt if I had seen any evidence that the medical community centered and valued my body, the bodies of my growing children. Now I have to navigate these same spaces with my two beautiful Black daughters, knowing that at any moment I may have to advocate for them to be treated equally. Thank God our pediatrician is Black.

In his song, “Make It Home,” Tobe Nwigwe’s lyrics speak the truth: “The world can be toxic. Especially when your skin look like chocolate.”

When a marginalized group of people never see themselves represented then it becomes the expectation. Anything outside of that feels abnormal. For us, the message is on repeat: We don’t matter. Even Johnson and Johnson’s recent “racially diverse” Band-Aids imply that Black and brown people were irrelevant until the pressure of diversifying products came in the wake of the 2020 protests against racial injustices. They’ve been selling one kind of “flesh-colored” Band-Aid since 1921.

But a Band-Aid can’t address the deeply rooted issues of racism in American health care practices. And we need a lot more than a Band-Aid to address the fact that medical students in every place that embraces a white, Euro-centric view of the world, aren't learning that Black bodies matter. The images in medical books that doctors learn from represent the whites-only experience. The ripple effect is that many Black patients have been overlooked, misdiagnosed, and mistreated. Michael Schwandt, a Vancouver-based medical health officer and assistant clinical professor, tweeted, “Pre-med, med school, medical residency — in 13 years of post-secondary training I can say I never once saw a black fetus illustrated. (Believe me, I'd remember.)”

I spoke with Kiarra King, a Black mother and Chicago-based OB-GYN, on the depth of how exclusively white depictions are harmful. She says it “further drives the message that white is the default, the standard. It’s a functional erasure of Blackness.” King also finds it interesting that here in the United States the institution of medicine was founded on the experimentation of Black enslaved people. “Yet here we are hundreds of years later in awe that we have been represented in a medical illustration.”

Suddenly we’re having these conversations — all because of a first-year medical student who created a solution. But Ibe didn’t stop at his fetus creation. He’s also illustrated Black people with skin conditions like vitiligo, eczema, and heat rash. Parents like myself are quick to access Google to determine what a mark on our child’s body may be. But skin conditions manifest differently for people with darker skin tones and we typically don’t have a base for comparison because all of the images we see when we Google are of white skin.

So to say this is a game-changer is an understatement. “As a physician, it confirms that we still have a long way to go, but that progress can be made,” King says. “I’m proud of the future doctor who is using his gifts and skills as an artist to contribute to the field of medicine in this way.”

Ibe’s art is a major disruption that’s bringing a welcomed warmth on our skin. The skin that is just as much here as white skin. The skin that deserves love, deserves to be healthy, and deserves to be acknowledged in every aspect of society.

My daughters are at the age where our anatomy conversations are getting more detailed as their desire for information increases. Ibe’s illustration will be the very first visual they see of a baby who looks like them, growing in a woman who looks like their mother. This one image reinforces all the lessons I’ve taught them about the beauty of our Blackness and that their space here matters. And it’s far past time for medical books to reflect that same messaging.