How The Real Housewives Helped Me Through My Own Black Maternal Health Crisis

At her Los Angeles home, Bozoma Saint John, an American-Ghanaian businesswoman and the latest cast member of The Real Housewives of Beverly Hills, contemplates an upcoming surgery to remove her fibroids. Boz, as she’s known, debates the decision in the latest season of the Bravo reality TV franchise; she tells her partner that she’s scared to go under anesthesia, but also about the necessity of the surgery to have a child in her late 40s. She also revealed her painful past experience with pregnancy loss. The rest of the RHOBH cast — an established line-up of mainly wealthy white women — visit Boz in bed as she recovers, yet spend most of the time discussing the latest drama of their troubled yet fabulous lives. The subject of Boz’s health, and Black maternal health in general, fades into the background of marriage breakdowns, warring friends, and Birkin bags.

I watched the episode from my bed, having also just had fibroid removal surgery, taking refuge in what is usually mindless reality TV viewing. As I watched (read: binged) all of Bravo’s Real Housewives franchises during my recovery, a pattern emerged: Real Housewives may be one of the best and consistent representations of Black maternal health struggles on mainstream television. It may be easy to write off these shows as frivolous reality TV but this representation truly does matter. 

To paint a picture: In Real Housewives of New York, season 15, model and businesswoman Ubah Hassan talked about her “excruciating” periods due to fibroids, the decision to meet with a specialist, and the desire to have a child in her 40s. Candiace Dillard Bassett shared her emotional IVF journey during season 7 of Real Housewives Of Potomac, meanwhile, fellow cast member Gizelle Bryant touched upon her decision to undergo a hysterectomy due to fibroids. In the Real Housewives of Atlanta — the Blackest cast of them all — Cynthia Bailey spoke of her painful and frustrating battle with fibroids with then-husband Peter (season 6), whereas, Kenya Moore’s much-discussed fertility issues led to frank discussions about her IVF journey at 47, by season 15, Sanya Richards-Ross, a former track athlete, bravely shared the heartbreaking news of her miscarriage before her second pregnancy. I can go on.

For those uninitiated into The Real Housewives universe, Bravo’s 20-year-old reality franchise series details the glamorous (yet messy) lives of America’s rich wives (and divorcees) and mothers hailing from Beverly Hills, the OC, New York, Atlanta, Utah, Potomac and elsewhere. It is a global success — sparking spinoffs in Dubai, South Africa, Cheshire, UK and more —  and viewing figures don’t seem to be waning. Despite their wealth, the cast members spend most of their time screaming at each other and gossiping about each other’s marital secrets. To put it mildly, both Bravo and its shows can be problematic: biases are often exposed as well as some of the castmembers legal issues (a few of the cast members have landed in prison; recently RHOP’s Karen Huger has been sentenced to 1 year in prison for a DUI), and a lot of the marriages fall apart in front of the camera. It is trash TV coated in diamonds. Yet there is sincerity to be found when watching this guilty pleasure if you choose to look for it; the cast have navigated addiction and alcoholism, supported each other through cancer, and encouraged mammograms. They have helped cast members through domestic abuse, the betrayal of infidelity, and so on. For me, the show has continually ignited necessary conversations about motherhood, Black women’s maternal health, fertility struggles, and gynecological health at a time when it’s most crucial. 

It isn’t purely coincidental that a large portion of the Black women on Real Housewives have been affected by fibroids; 80% of Black women globally suffer from fibroids, benign, non-cancerous tumours that can grow inside the womb and cause heavy bleeding. Fibroids can be the cause of miscarriages and fertility issues; they can also put women and babies at risk during the antenatal period, although this is considered rare. Despite the pain caused to a widespread number of Black women, there is still limited understanding about why Black women are the most affected by the condition and its cause. This is the story for many health issues where Black women are overrepresented.

For the last five years, the state of Black maternal health outcomes has come into purview. At a glance, based on global data, Black women are 43% more at risk of having a miscarriage than white women. Last year, new research revealed that the United States continues to have the highest rate of maternal deaths of any high-income nation — and the rate is by far the highest for Black women. Federal health data has confirmed that while maternal deaths have fallen since the pandemic, the racial disparity has widened, and Black women are three times likely to die during pregnancy than women of other races. In the UK, where I am from and live, Black women are four times more likely to die during childbirth than white women. Black maternal health campaigners and health professionals have been working to understand the racial biases within healthcare that lead to these poor outcomes, including the misconception that Black women can tolerate more pain than other races and the fact that our symptoms are often wrongly dismissed.

What’s clear is that raising awareness for Black maternal health is still crucial, especially when Black women’s pain — both in and out of motherhood — can feel like an invisible struggle. 

When I watched Real Housewives from my sick bed, it was an extremely lonely time. Dealing with a chronic health issue such as fibroids and life-altering anemia for three years meant not everyone understood how much pain I was in. It has been excruciating. I learned firsthand what it’s like to be routinely dismissed by medical professionals and to live and work in extreme discomfort as a result of a lack of care. Because I was dealing with extremely heavy periods, multiple blood transfusions, and had quietly gone through a miscarriage, a lot of people in my personal life felt too uncomfortable to talk about it. It was only when I was told that I desperately needed surgery that the severity of a condition like fibroids was understood.

The Black women in The Real Housewives and Married to Medicine (a Real Housewives spinoff that sees the lives of Black women gynecologists take center stage) have discussed these issues head-on in their series, providing me with unexpected comfort. Porsha Williams of The Real Housewives of Atlanta has seen her fair share of dramatic storylines, but the mom-of-one’s decision to speak about systemic racism in the medical field is often overlooked. In 2020, Williams opened up about a miscarriage she endured before giving birth to her daughter. Speaking to Bravo’s Daily Dish, Williams said, “With my first miscarriage, I was actually sent home about three or four different times telling them that I was in pain, and I felt like I was going to have a miscarriage. And it just goes back to doctors feeling like Black women have this serious threshold for pain,” she said to Bravo. “I ended up having fibroids, and that’s what was causing it, is what caused so much stress on my body that I ended up having a miscarriage.” 

Sharp-tongued, witty, loud and outspoken, the Black women of The Real Housewives are often criticized for the things they say and their behavior, and while they offer a lot to pop culture and meme culture, a lot of the criticism they face is rooted in misogynoir (because ALL of the cast members are loud, outspoken and like to argue). Yet, it is their candidness to speak about their lives on camera that is encouraging conversations in so many homes — and that should be applauded.

Recently, there have been renewed conversations about how the art of television-making can be used as a vehicle to inspire societal change. Netflix’s Adolescence, Jack Thorne and Stephen Graham’s rousing drama-series about youth gender violence, incel culture and the manosphere, pushed the UK Prime Minister, Keir Starmer, to support the series being shown in British schools as a means to educate students. The decision has led to social media jokes suggesting that Adolescence’s creators roll out more single-shot series about other societal issues to encourage political leaders to take action. Does a television series need to be highbrow to inspire needed conversation? I don’t necessarily think it does. 

The latest season of Real Housewives of Atlanta pulled in 2.5 million viewers in its debut week — mostly due to the series’ controversial storyline with suspended original member, Kenya Moore. The reality show’s popularity amongst mainly women audiences is clear. As campaigners such as the Black Mamas Matter Alliance, The Black Maternal Health Caucus, and FiveXMore in the UK continue to raise awareness about the current state of Black maternal health, one of the biggest reality show series is playing its part — regardless of whether there’s a lot of drama in between. 

Of course, I have to note that these women are extremely wealthy, and their access to necessary healthcare in the US will be decidedly easier than for the average American. It does not show the low rates of Black women able to receive prenatal care compared to other groups, for example. As a Black British woman who is neither wealthy nor living in America, I don’t entirely relate to the casts of this reality franchise (partly why I enjoy reality shows in the first place). However, when it comes to how it feels to navigate a healthcare system that doesn’t always see *us* regardless of our class and status — well, we’re not all that dissimilar. 

I am not naive, I understand that inauthenticity is rife in reality shows in 2025. Gone are the unfiltered shabbiness of earlier series, and reality stars are much more media savvy. Much of the “reality” scenes are orchestrated by producers, and between the forced beef and obvious ploys to shock viewers, not much of what’s shown is created by accident. And yet, life always happens, and the women are often compelled to share the whole truths of their lives —  the emotional journey of motherhood, the messy parts of marriage and friendships, and the beautiful complexities of Black womanhood — because it’s the unavoidable consequence of living. And in doing so, during a time I needed it most, they made me feel less alone.