You have probably heard the story of Tashonna Ward, the 25-year-old Milwaukee woman who recently spent hours in the emergency room due to shortness of breath and died after waiting too long. Ward was told that she would spend between two to six hours in wait time at the ER according to distressing posts on her Facebook page. Preliminary tests were performed on Ward and showed she had cardiomegaly, an enlarged heart, but she was never admitted despite having chest pains and tightness of breath.
After waiting 2 hours and 29 minutes in the ER, Tashonna Ward and her sister decided to go to urgent care. She never made it. She passed out en route and collapsed and died in the urgent care parking lot. The cause of death: hypertensive cardiovascular disease.
While many reports mentioned the emergency room wait times that led to Ward’s death, a few have reported that she developed cardiomegaly due to pregnancy complications from a miscarriage in March of 2019. In fact, the Milwaukee County Medical Examiner’s Report states that the “decedent did develop cardiomegaly during pregnancy.”
“decedent did develop cardiomegaly during pregnancy.”
Milwaukee County Medical Examiner Report from January 14, 2020
Now that 2020 is in full swing I decided to catch up on the many maternal health and mortality articles that were published during the holiday season. There has been a lot of stellar reporting that you might have missed. I did. Here is a compilation of some of the articles I found the most compelling starting with a wrap-up post, 7 things I learned from spending a year reporting on mothers in Alabama, by Anna Claire Volle about the excellent year-long reporting she did on mothers in Alabama. I particularly liked
[NBC News] ‘Extremely alarming’: New report addresses maternal mortality in the U.S.: Taraneh Shirazian, director of Global Women’s Health at NYU’s College of Global Public Health and president of Saving Mothers discusses on Morning Joe how maternal mortality has decreased globally, but in the United States maternal deaths have increased particularly for black moms.
[The Hill]Reproductive revolution: Ending black maternal health inequities in 2020: Tracey Lewis-Elligan, an associate professor & chair of Sociology at DePaul University, details the ways in which black mortality can be decreased starting this year. She highlights some of the work of doulas and midwives in the fight against black maternal mortality.
The CDC released a new report late last week, Racial/Ethnic Disparities in Pregnancy-Related Deaths — United States, 2007–2016, that reiterates the maternal mortality disparity between black mothers and American Indian/Alaska Native women and white, Hispanic, and Asian/Pacific Islander women. The numbers now seem worse than we originally thought. For example, black women who are college educated die in larger numbers than white women with less thana high school diploma. And, even in states where overall maternal mortality is low, black women still die in larger numbers.
In addition, the CDC acknowledges that “black women experience earlier deterioration of health because of the cumulative impact of exposure to psychosocial, economic, and environmental stressors.” In other words, a contributor to maternal death rates among black women is structural racism in healthcare settings.
One of the leading causes of maternal mortality in the United States is hemorrhaging. In fact, according to the CDC hemorrhaging accounts for 11.2% of pregnancy-related deaths. Based on these increasing numbers since 1986 the Joint Commission, the country’s leading accreditation organization for hospitals, has created 13 new standards for perinatal safety for hospitals to properly care for women who hemorrhage during or after delivery. These standards were designed specifically to prevent, recognize and treat, as well as evaluate patients for transfer to critical care for not only hemorrhage but also severe hypertension/preeclampsia.
On Tuesday the first congressional caucus on black maternal health launched on Capitol Hill. Led by Democrat congresswomen Rep. Alma Adams (D-NC) and freshman Rep. Lauren Underwood (D-Il.) the caucus’s mission is to ensure black women are not dying senselessly during or after childbirth
As has been noted here many times before black women experience maternal mortality rates four times higher than white mothers no matter black women’s socioeconomic status or even the level of education achieved. In general, the United States has the highest maternal mortality rate of any developed country. Black women fare the worst.