Mothers, Especially Black Mothers, Keep Dying from Childbirth

By Matthew Nace | July 13, 2023

Mothers, Especially Black Mothers, Keep Dying from ChildbirthThe first descriptor that pops up when we look at stories about Tori Bowie is that she was an Olympian. Then, those stories  mention that she took the gold medal in Rio. Then, they say she died from complications of childbirth.

The Associate Medical Examiner in Orange County labeled her death as “natural causes… citing evidence of Bowie undergoing labor when she died.”

Let us be clear: there is nothing natural about what’s happening here.

Yes, women have died in childbirth since the earliest recorded human history. But the numbers are getting worse: the Centers for Disease Control and Prevention reports that “in 2021, 1,205 women died of maternal causes in the United States compared with 861 in 2020 and 754 in 2019.”

And Black women are dying more often than White women or Hispanic women: “In 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6). Rates for Black women were significantly higher than rates for White and Hispanic women.”

This isn’t new. We talked about the maternal mortality rate for Black women in 2018. We talked about the 2013 data from the Institute of World Health Metrics and Evaluation that showed maternal fatalities were rising. And yet things haven’t gotten better. They’ve just gotten worse. So when we say there is nothing natural about what’s happening here, this is what we mean. How is it that in America, one of the most scientifically advanced nations in the world – a country where billionaires can literally fly into space – mothers keep dying in childbirth?

Preeclampsia is still a serious concern for mothers

After USA TODAY published its exposé about maternal mortality rates, we saw countless articles and think-pieces about how doctors, hospitals and staff could reduce the number of deaths from childbirth. We saw states pass laws to help reduce the number of maternal deaths, and to identify potential risks. We read articles about hypertension and hemorrhage and preeclampsia, a potentially deadly increase in blood pressure that can lead to eclampsia, which can lead to seizures, coma, or death.

The Washington Post reports that this is what killed Tori Bowie: “eclampsia, the most severe condition on the spectrum of pregnancy-related hypertensive disorders, and respiratory distress, which can happen when blood pressure gets too high.”

Of course, not all mothers die from preeclampsia – but “almost dying” is still an incredibly traumatic experience, and yet the data keeps getting worse. From The Post:

Much more common but often overlooked are the near misses, the life-threatening complications experienced before, during and after childbirth. Research shows that for every maternal death, about 100 women experience severe maternal morbidity, meaning childbirth would have been nearly lethal for about 120,500 women in 2021.

It’s worse for Black women and women of color

Per the paper, “This life-or-death scenario is particularly true for Black women, who are twice as likely to suffer serious complications during pregnancy and three times as likely to die, regardless of income or education.”

But why? Studies point to systemic, implicit bias in healthcare. Sometimes, it’s a doctor who’s been practicing for 20 years and makes assumptions based on past cases, instead of ordering the tests. Sometimes, it is because one member of a team assumes everything on the chart is correct and doesn’t double check.

And sometimes, it’s because medical professionals suffer the same racial biases as non-medical professionals. The Kaiser Family Foundation has tirelessly reported on racial bias in healthcare, from diagnostics through treatment. Even the American Medical Association recognizes that racism is a public health threat, including systemic racism in healthcare.

These biases are causing real world harm, even now. From the Post:

[Erika] Weathers, an assistant professor at the University of Pennsylvania Graduate School of Education, has noticed how medical professionals talk to her in a much different tone when they learn about her career and education. That wasn’t always the case. When she was a doctoral student at Stanford University and pregnant with her first child, providers dismissed her questions during prenatal visits, which felt rushed.

So when she didn’t feel her daughter move for hours, Weathers hesitated before calling the doctor, worried that doctors would think she was overreacting. She wasn’t. Her blood pressure had spiked to dangerous levels that can trigger a seizure or stroke. She had an emergency Caesarean section, hemorrhaging to the point that she required a blood transfusion.

Stories like these are seemingly endless and they are all heartbreaking. We are living in a golden age of medicine. Surgery is done by robots. There may be a viable cure for HIV.

Yet the number of mothers-to-be who can access prenatal care is still dropping. And mothers are still dying from preventable and treatable conditions.

There is nothing natural about this.

We’ll keep fighting to protect mothers and their children

We’re angry, but we’re not hopeless – and you don’t need to be, either. Washington, D.C.’s Department of Health Care Finance lists a number of resources for mothers and mothers-to-be (and fathers, too), including information about:

They also provide a list of local DC community resources, as well as DC’s government resources. So there is access to care for families in our community.

We continue to fight for better legislation. For example, under the American Rescue Plan Act of 2021, the District of Columbia was able to expand Medicaid access for pregnancy and post-partum care, so that’s a step in the right direction. But we know there is more to be done, and we will not back down until all mothers are safe.

Please call or contact Paulson & Nace, PLLC through this contact form.

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