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.