Serena Williams — And Other Black Women — Face Terrifying Levels of Risk in Pregnancy

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Debbie says:

Last September, Serena Williams — and it is hard to imagine a healthier woman — gave birth to her daughter, Alexis Olympia Ohanian. The baby was fine, but Williams almost died.

In December, Nina Martin of Pro Publica and Renee Montagne of NPR released their terrifying article on black mothers’ risk of death in pregnancy and childbirth.

… a black woman is 22 percent more likely to die from heart disease than a white woman, 71 percent more likely to perish from cervical cancer, but 243 percent more likely to die from pregnancy- or childbirth-related causes. In a national study of five medical complications that are common causes of maternal death and injury, black women were two to three times more likely to die than white women who had the same condition.

Martin and Montagne use the story of Shalon Irving, an educated, insured, supported black woman as the lead-in to their story. Irving died three weeks after her baby Soleil was born, from complications of high blood pressure.  Irving’s story is all too common:

In New York City, for example, black mothers are 12 times more likely to die than white mothers, according to the most recent data; in 2001-2005, their risk of death was seven times higher. Researchers say that widening gap reflects a dramatic improvement for white women but not for blacks.

The disproportionate toll on African-Americans is the main reason the U.S. maternal mortality rate is so much higher than that of other affluent countries. Black expectant and new mothers in the U.S. die at about the same rate as women in countries such as Mexico and Uzbekistan, the World Health Organization estimates.

What’s more, even relatively well-off black women like Shalon Irving die and nearly die at higher rates than whites. Again, New York City offers a startling example: A 2016 analysis of five years of data found that black, college-educated mothers who gave birth in local hospitals were more likely to suffer severe complications of pregnancy or childbirth than white women who never graduated from high school.

Sure, some of the numbers come from low-income mothers without access to good insurance, good doctors, or healthy food. And I have internalized Michael Twitty‘s insight that even for people with access to a generation, or two, or three, of healthy food, a century or more of a slave’s diet will still sit in their genes. But Martin and Montagne focus on the pure racism at the heart of this heartbreaking inequity:

 

In the more than 200 stories of African-American mothers that ProPublica and NPR have collected over the past year, the feeling of being devalued and disrespected by medical providers was a constant theme.

There was the new mother in Nebraska with a history of hypertension who couldn’t get her doctors to believe she was having a heart attack until she had another one. The young Florida mother-to-be whose breathing problems were blamed on obesity when in fact her lungs were filling with fluid and her heart was failing. The Arizona mother whose anesthesiologist assumed she smoked marijuana because of the way she did her hair. The Chicago-area businesswoman with a high-risk pregnancy who was so upset at her doctor’s attitude that she changed OB/GYNs in her seventh month, only to suffer a fatal postpartum stroke.

Her anesthesiologist assumed she smoked marijuana because of the way she did her hair. And, of course, because of the color of her skin. You can bet your last cent that a white woman who did her hair the same way wouldn’t have drawn the same assumptions.

Martin and Montagne go on to discuss the daily stress in the lives of successful black women, identifying it as a factor perhaps as important as medical racism. It seems to me that the two are so inextricably linked that discussing them separately does the otherwise brilliant story a disservice. Black women (and men) live with constant stress because of systemic racism, and that systemic racism is no less prevalent in the medical system than anywhere else. They then go back and fill in many details of Shalon Irving’s story, in detail that would be beautiful if it was a success story, but is crushing because we know Irving is dead.

Serena Williams, who could easily have been a mortality statistic five months before Irving became one, was both forceful and lucky:

The next day, while recovering in the hospital, Serena suddenly felt short of breath. Because of her history of blood clots, and because she was off her daily anticoagulant regimen due to the recent surgery, she immediately assumed she was having another pulmonary embolism. (Serena lives in fear of blood clots.) She walked out of the hospital room so her mother wouldn’t worry and told the nearest nurse, between gasps, that she needed a CT scan with contrast and IV heparin (a blood thinner) right away. The nurse thought her pain medicine might be making her confused. But Serena insisted, and soon enough a doctor was performing an ultrasound of her legs. “I was like, a Doppler? I told you, I need a CT scan and a heparin drip,” she remembers telling the team. The ultrasound revealed nothing, so they sent her for the CT, and sure enough, several small blood clots had settled in her lungs. Minutes later she was on the drip. “I was like, listen to Dr. Williams!”

How did she know that? Because she has a history of pulmonary embolisms, and knows what they feel like. She was right, and she had — and used — the power to make the doctors listen to her, or Alexis Olympia could be motherless, as Soleil Irving is.

Now, Williams is speaking out about black women’s risk in the United States and around the world. She gives her doctors a lot of credit, perhaps more than they deserve if the story above is true.  And then she issues a call to action:

According to UNICEF, each year, 2.6 million newborns die, tragically before their lives even really get started. Over 80% die from preventable causes. We know simple solutions exist, like access to midwives and functional health facilities, along with breastfeeding, skin-to-skin contact, clean water, basic drugs and good nutrition. Yet we are not doing our part. We are not rising to the challenge to help the women of the world. …

You can demand governments, businesses and health care providers do more to save these precious lives. You can donate to UNICEF and other organizations around the world working to make a difference for mothers and babies in need. In doing so, you become part of this narrative — making sure that one day, who you are or where you are from does not decide whether your baby gets to live or to die.

Together, we can make this change. Together, we can be the change.

It’s impossible to argue with Williams’ impassioned plea to save mothers and babies around the world … She’s using her prominence for good, and I applaud her wholeheartedly.

At the same time, having read Martin and Montagne’s article, I want us to save mothers and babies around the world and find ways to balance, minimize — or best, erase — the systemic racism killing black mothers right here in my country, my state, and my city.

Living in Weimar 7: Persecution of the “Unfit”

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Laurie and Debbie say:

When the Nazi Party ran Germany before and during World War II, one of their openly stated goals was to remove the “unfit” or “useless” — people we would call “disabled — from society, first by sterilization and later by mass murder. “Compulsory sterilization and “euthanasia,” like the ‘Final Solution,’ were components of a biomedical vision which imagined a racially and genetically pure and productive society, and embraced unthinkable strategies to eliminate those who did not fit within that vision.” In fact, the killing of the ‘unfit” was their trial run toward the genocide they are most remembered for today.

As we have throughout this series, we need to stress that the contemporary Republicans, despicable as they are, are not Nazis, and that Trump is not Hitler. The attacks on the disabled in our time use different rhetoric and different tactics … and are terrifying in their intent and scope. We also need to remember that the Nazis and the Germans neither invented nor owned the ideas of eugenics and genetic purity: the movement has a long, ugly history in many places, and was very strong in the United States starting about 120 years ago, continuing well into the 20th century.

s.e. smith, a writer we’ve been following almost as long as we’ve been blogging together, wrote brilliantly about this for Rewire, shortly after the Nazi demonstrations in Charlottesville last August:

It shouldn’t come as a surprise, then, to learn that white supremacists and their allies also embrace eugenics rhetoric. Their narrative of whiteness as superiority does not include disabled people, regardless of race, though they often cloak their bigotry in arguments about “human biodiversity,” an ideology that asserts genetics determine intelligence, athleticism, and behavior. Meanwhile, white nationalists and the right more broadly revel in disablist rhetoric like the use of “libtards” (a portmanteau of “liberal” and “retard”) and accuse disabled people of “faking it” and sucking government resources. Take, for instance, Steve Bannon asserting “genetic superiority” or Jeff Sessions praising an outdated immigration law that restricted entry on the basis of disability. Disabled people, it is implied, are very much not welcome in these movements.

Here, as everywhere, we see the entanglement of the neo-Nazi movement, who could once be considered small and somewhat marginalized, with the people in the hall of power. No one who works in Trump’s White House or sits in the U.S. Congress was marching in Charlottesville last summer (as far as we know). But it’s clear where the sympathies of far too many of them lie.

For the disability community, there’s a lot at stake in resistance to white supremacy, starting with the fact that many disabled people are targets for white supremacist movements because of their race or faith. And the government’s failure to act on, and sometimes its complicity with, a movement with eliminationist tendencies is worrisome to those concerned about their survival in Trump’s United States. Notably, people of color are statistically more likely to be disabled in the first place. A variety of factors contribute to this differential diagnosis of disability, including the interactions of disability and poverty, occupational injuries, and health-care discrimination.

White disabled people have an inherent moral imperative to work in solidarity with their disabled siblings of color, and to be the first to put their bodies and lives on the line. That’s something disabled protesters of all races are well accustomed to—they’ve been doing it for months to resist Republican attacks on health care—but in racialized attacks, white people can and must use their privilege for good. Failure to do so enables and perpetuates white supremacy.

As we know, the disability community was crucially important in stopping the health care bill … and crucially important in the failed attempt to stop the new tax law. Existing U.S. health care policy is being attacked from other directions since the legislative attempt failed, and the tax law — disastrous and draconian for almost everyone who doesn’t already have a gold-plated swimming pool — is particularly punitive to disabled people, among other groups. Jordan Davidson provides some details in The Mighty:

According to the Congressional Budget Office, the bill will cut Medicare by $25 billion in 2018. The bill also removes the individual mandate required by Obamacare, which forces those without insurance to pay a “penalty.” These penalties have led more people, including healthy people, to sign up for health care. Without the mandate — which ends as of 2019 — analysts are concerned that healthy people will leave the marketplace and, by forgoing penalty, will leave Obamacare without adequate funding, further increasing premiums and deductibles.

“By reducing revenue by at least $1.5 trillion, the Tax Cuts and Jobs Act increases the pressure to cut Medicaid and other programs that are critical to the lives of people with intellectual and developmental disabilities,” Peter Berns, CEO of The Arc, said in a statement. “Each vote in favor of this bill was a vote against constituents with disabilities and sets the wheels in motion to quite possibly go back in time to an era when people with disabilities had little opportunity to live a life of their choosing, in the community.”

Mass sterilization and mass murder are not the 21st century Republican order of the day. Instead, their actions lead toward the goal of making sure that disabled people — and their families — have no options, nowhere to turn, and no quality of life. We personally know of two suicides since Trump’s election that were directly related to lack of access to health care — two of hundreds, if not thousands.

Protests like the ones pictured at the top of the article represent the readiness of the disabled community to fight back, the readiness of the people in power to stop them, and the readiness of the police to follow inhumane orders. Just as s.e. smith lays out the moral imperative for white disabled people to work in solidarity with their disabled siblings of color, able-bodied folks like the two of us have a moral imperative to work in solidarity with our disabled siblings. Period.