A few years ago I was honored to speak at Blogher with Merck for Mothers. The panel was about maternal health outcomes globally as well as in the United States. As I have mentioned so many times on this blog, the United States leads the developing world with maternal health deaths. This number is exaccerbated by the sheer number of black women who die from pregnancy and delivery complications.
One of the key points we honed in on during the panel was the importance of women being advocates for themselves with their healthcare providers when they feel something is wrong. But, that is not always easy. Take Serena Williams for example. She basically had to beg doctors and nurses to get a CT scan to see if her lung had blood clots which she routinely got as an athlete. They finally relented and what did they find? Blood clots in her lungs. Serena saved her own life.
Many women, especially black women, are not afforded the opportunity to simply get a doctor or nurse to believe that they do not feel well and oftentimes their lives are hanging in the balance. In fact, NPR and ProPublica gathered over 200 stories from black women who felt that they had been “devalued and disrespected by medical providers” during their pregnancies.
I regularly watch a Youtube channel called R&L Life, a cute family channel out of Florida. The mother, Rachael, recently delivered her son and a few days later she had preeclampsia symptoms with massive swelling and high blood pressure. She and her husband went to her doctor only to discover she could have a seizure at any time because of her high blood pressure. She needed to be rushed to the hospital for oral medication and a magnesium drip.
United States maternal death statistics that have been used for over a decade have finally been updated. The CDC released 2018 national and state maternal death estimates last week. The numbers have increased dramatically and still remain the worst of any developed country in the world.
Currently, the maternal mortality rate (MMR) is 17.4 deaths per 100,000 live births. In 2007, the MMR was 12.7 deaths per 100,000 live births. The CDC says the MMR increase largely comes from the new data and collection requirements now on standard death certificates. Starting in 2003, a checkbox requirement was placed on the U.S. Standard Certificate of Death in order to accurately record maternal deaths. The checkboxes are:
Not pregnant within past year
Pregnant at time of death
Not pregnant, but pregnant 43 days to 1 year before death
Not pregnant, but pregnant within 42 days of death
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.”
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
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.