Black women’s reproductive health and medical bias

Black women’s reproductive health and medical bias emerges through Queenie Jenkins’s miscarriage while she has an IUD, an encounter in which clinical information arrives without emotional recognition. The novel places that exchange beside Maggie’s warnings about contraceptive control, Queenie’s own distinction between preventing pregnancy and losing the freedom to choose, and later appointments where she must disclose what happened. Together, these scenes ask what reproductive autonomy means when medical care, inherited community knowledge, and racialized assumptions all shape how a Black woman understands her body.

The miscarriage and clinical response

Queenie learns about the miscarriage during a medical examination after the doctor returns to check the ultrasound and seeks a second opinion. The doctor asks whether pregnancy was possible, then explains that the scan appears to show a miscarriage. Queenie’s surprise is sharpened by the fact that she has an IUD: earlier, she had been told that it was in place. The scene does not establish that the device caused the pregnancy or the loss. Instead, it exposes a gap between relying on contraception and knowing what has happened in one’s body.

When Queenie asks why, the doctor gives a clinical explanation, saying that miscarriage can occur with most forms of contraception and that many women may not know. She then adds that, at least, the contraception had done its job. The remark reduces the encounter to contraceptive effectiveness just as Queenie is trying to make sense of a loss. The doctor keeps her attention on the ultrasound rather than acknowledging Queenie’s visible distress; Queenie wants the news to be recognized as something that has affected her. The emotional force of the scene lies in that mismatch: information is supplied, but care does not meet the patient where she is.

The physical aftermath continues beyond the appointment. At home, Queenie finds that the bleeding has stopped but the cramps remain. In the bath, she considers both the pregnancy she did not intend and the choice the miscarriage has taken away. At twenty-five, she is clear that she was not planning to have a baby. Yet she also recognizes that deciding not to carry and raise a child is different from never having the opportunity to decide. Her mother became pregnant at the same age, a comparison that makes Queenie think about her own readiness without changing what she wanted. The scene holds these feelings together rather than treating grief as proof that she wanted motherhood.

Maggie’s counter-history and contested knowledge

On a bus, Maggie responds to Queenie’s medical experience with a history of reproductive control as she understands it. She says that, when her mother came to Britain, implants and IUDs were placed in Black women without their knowledge to prevent pregnancy. She recalls a family friend, Glynda, who could not become pregnant for years and did not know why. Maggie uses these stories to question not only Queenie’s physical experience of an IUD but the politics of having one fitted at all.

Maggie also makes broader claims that Black women’s bodies do not work well with this kind of contraception, invoking chemical imbalance, melanin, the pineal and pituitary glands, and swelling. The narrative presents these as Maggie’s assertions, not as medical findings confirmed by Queenie’s doctors or by the events. That distinction matters: the scene gives space to community knowledge and historical suspicion, while also showing how fear and explanation can travel together when formal care has not made Queenie feel understood. Maggie’s urgent, expansive manner contrasts with the doctor’s restrained clinical delivery, but neither exchange gives Queenie a complete account of what happened to her.

Follow-up, disclosure, and reproductive choice

The miscarriage remains part of Queenie’s later interactions with healthcare providers. During a sexual-health appointment, she asks for a pregnancy test despite having an IUD. When the nurse points out the device, Queenie struggles to explain; the nurse supplies the possibility she cannot say aloud, and she confirms that she has been pregnant. Her nervous laughter about coming from a fertile family briefly softens the disclosure, but does not erase its weight. The request shows that the earlier pregnancy has changed how she approaches the possibility of pregnancy, even with contraception in place.

The same appointment includes screening for sexually transmitted infections. The nurse raises concern that Queenie’s injuries are largely consistent with sexual violence and asks whether she has someone she can confide in. Queenie rejects the implication that she is covering for an abusive boyfriend. The scene does not establish a link between those injuries and the miscarriage; its relevance is that reproductive and sexual healthcare brings Queenie into contact with questions about bodily safety as well as pregnancy. She encounters care that can identify a concern, but also has to decide what she can disclose and how she will be understood.

At a subsequent hospital visit, Queenie is told that the fetal tissue has passed. Because pain has returned after sex with Adi, she is given antibiotics to guard against possible infection. She weighs whether Tom should know about the miscarriage, separating that information from what she does not want to tell him. Her uncertainty shows that the event cannot be neatly contained by the rules of their separation: it belongs to her body, but also touches the relationship she has left. Medical follow-up confirms a physical outcome, while the personal meaning remains unresolved.

Racialized bodies and the limits of choice

These reproductive scenes sit within a wider account of how Queenie’s Black body is read and treated. In a later conversation with Kyazike, Queenie says she fears Black men and worries that past relationships have left her damaged. In therapy, she describes being categorized through racialized labels at work and in public, and contrasts the romantic attention her friends receive with men’s sexual propositions toward her. These experiences are not evidence that every medical encounter is racially biased, nor does the novel make them a substitute explanation for the miscarriage. They establish a broader social setting in which Queenie’s body is repeatedly made available for other people’s interpretations and desires.

The account therefore refuses a simple choice between contraception as protection and pregnancy as desire. Queenie can be certain she did not want to raise a child and still mourn the loss of an uncoerced choice; she can receive medical explanations and remain without an emotionally adequate answer. Maggie’s warnings add the historical fear of reproductive coercion, while the clinical scenes expose the limits of information delivered without recognition. The theme’s central distinction is between having contraception and having informed, respected agency over one’s reproductive life.