Black women are often ignored by medical care providers... and Serena Williams's childbirth story proves it

Black women are often ignored by medical care providers... and Serena Williams's childbirth story proves it

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"That was an amazing feeling," 23 Grand Slam singles winner and tennis icon Serena Williams told Vogue's writer Rob Haskell, describing the moment when her wailing new-born daughter was placed in her chest, seconds after being born.

"And then everything went bad...," she further revealed.

Serena came face-to-face with the greatest opponent of her life — death — when she faced life-threatening medical complications that came unannounced during her childbirth in September last year. Coupled with, what she calls, a racial bias that is omnipresent in the American medical industry, her opponent this time could have won against her, had she not received the medical attention in time.

In Vogue’s February cover story, Serena recalled how she dealt with serious childbirth complications shortly after the birth of her daughter, Alexis Olympia. Married to Reddit co-founder Alexis Ohanian, Serena explained in detail about how the medical issues commenced immediately after the day Alexis was born via Cesarean section when she fell short of breath.

With a history of pulmonary embolisms (Serena underwent emergency treatment for embolism in 2011), Serena alerted a nurse about her symptoms and called for assistance.

But what happened next, left her dumbfounded.

In an article published in Vox, Vogue writer Rob Haskell explained: "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 to 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!”

According to the Vogue article, she "spent the first six weeks of motherhood unable to get out of bed."

With the fear of a C-section rupture due to the intense coughing that had ensued because of embolisms, Serena was later placed in surgery during which doctors found out that a hematoma had filled her abdomen as a result of blood thinners. A filter was placed into one her major veins to keep more blood clots from passing to her lungs.

Post her surgery, Serena needed six weeks of bed rest.

Are black women in America facing a silent maternal-heath crisis?

Serena's case opens a bag of worms that has gnawed the very foundations of American medical healthcare system since long.

And Serena's case isn't the only high-profile case that highlights the problem.

Activist Erica Garner, who drew country-wide attention with her organized protest-movements for her father Eric Garner, the latter who passed away in Staten Island on July 17, 2017; after an NYPD officer put him in a chokehold, also died after going into cardiac arrest, following a medically induced coma.

Erica, who had given birth in August last year to her second child, is one among the many alarming numbers of women in the US who have died during pregnancy or within one year of childbirth.

But sadly, the crisis has affected black women in large numbers, compared to women belonging to different racial backgrounds. The Centers for Disease Control and Prevention had earlier stated how black women are three to four times more likely to die from complications pertaining to pregnancy, than white women.

The aforementioned two cases also highlight the number of black women who have been afflicted by the lack of medical attention in pregnancy cases every year in America.

The question remains: Why?

“The combination of institutionalized racism, chronic stress, and the physical stress of childbirth can be deadly, and some believe that this was the case for Garner, as it is for so many Black women in the United States,” Katie Mitchell told Bustle. “And as we mourn [Garner’s] loss, we need to have a conversation about why maternal mortality disproportionately affects Black women in the US, and what can be done about it,” she wrote further.

In the US, childbirth has become even more dangerous. Maternal mortality — defined as the death of a mother from pregnancy-related complications while she’s carrying or within 42 days after birth — in the US soared by 27 percent, from 19 per 100,000 to 24 per 100,000, between 2000 and 2014.

“It’s a travesty,” Maryland researcher Marian MacDorman, a researcher luminary in the field of US maternal mortality, who had presented one of the best paper on the said topic in 2016, said. “Mongolia has a maternal mortality rate, and the US with all our wealth and health care can’t publish a maternal mortality rate,” she added ruefully.

The number of deaths in America is three times higher than the rate of the United Kingdom, and about eight times the rates of Netherlands, Norway, and Sweden, according to the OECD.

ProPublica and NPR, who have presented an in-depth maternal mortality project, stated that a number of these deaths can be avoided. However since systemic discrimination and racism continue to thrive in our society, including the medical industry and healthcare, black women are affected largely than any other racial group, who die from pregnancy-related complications.

Many black women took to Twitter to point out how Serena's pregnancy scare proves the existence of discrimination present large in the society and how incredibly difficult it is for black women across all income-groups to receive the care they need.

It doesn't help either that the American healthcare system is notorious for managing complicated pregnancies with a glaring lack of precision and accurate preparation. In fact, women who give birth in the States are at a higher risk of dying compared to other first-world nations.

The issue has been growing unhindered and the reasons attributed to the spike, are several. One reason behind the said growth is partially due to how maternal deaths are codified on death certificates. In the 1980s, health officials realized that maternal deaths were being inadequately reported, which led to better reporting.

But that's not all.

The diminishing access to contraception and abortion in several parts of the US has also contributed to an increase in unplanned and unwanted, even life-threatening pregnancies.

In Boston University's maternal health expert Eugene Declercq opinion, the primary issue at hand is lack of respect for pregnant women.

“The argument we make internationally is that [a high maternal death rate] is often a reflection of how the society views women,” he told Vox's Julia Belluz. “In other countries, we worry about the culture — women are not particularly valued, so they don’t set up systems to care for them at all. I think we have a similar problem in the US,” he asserted.

ProPublica’s Annie Waldman explained how black women are being affected by the maternal crises and why they are unable to get out of the callous circle.

"Even when accounting for risk factors like low educational attainment, obesity, and neighborhood poverty level, the city’s black mothers still face significantly higher rates of harm, the agency found. Of note, black mothers who are college-educated fare worse than women of all other races who never finished high school. Obese women of all races do better than black women who are of normal weight. And black women in the wealthiest neighborhoods do worse than white, Hispanic and Asian mothers in the poorest ones."

"The health department has even mapped where the most maternal harm occurs, dividing the city into community districts. The highest rates of complications are concentrated in a swath of land in Central Brooklyn, in an area largely untouched by the wave of gentrification that has swept other parts of the borough. Here, mothers face up to four times the complication rates of neighborhoods just a few subway stops away."

Statistics by ProPublica further corroborate how black women are 243 percent more likely to die from pregnancy- or childbirth-related causes, leading to the creation of one of the largest racial disparities to exist in women’s health department.

In a report published in December on black-women pregnancy-related deaths, journalists Nina Martin and Renee Montagne summarised incidents of how black women were facing bias when receiving pregnancy-related care:

"The feeling of being devalued and disrespected by medical providers was a constant theme. 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."

"Over and over, black women told of medical providers who equated being African American with being poor, uneducated, noncompliant and unworthy. “Sometimes you just know in your bones when someone feels contempt for you based on your race,” said one Brooklyn woman who took to bringing her white husband or in-laws to every prenatal visit."

It doesn't help to know that the American health care is infamous for siphoning black women to inadequate medical facilities, completely ignoring or being dismissive of their health struggles.

But the issue is even graver than one can understand. The usual reports are centered around black women who die from complications in the time-frame before and after childbirth, leaving those who die in the weeks and months after delivery, like Garner, scarcely reported.

With limited and in most cases, inadequate health care access is a problem, the topic of about exactly how budget cuts to women’s health programs have affected the crisis, is mootable. But the issue is omnipresent and remains unaffected by the rural versus urban city presence too. Like ProPublica noted, in New York City, Erica Garner’s hometown, “black mothers are 12 times more likely to die than white mothers.”

One fact is crystal clear: the maternal mortality crises affects black women more than any other racial group.

“This is a national tragedy, [but] we aren’t doing the research that’s needed and could hold hospitals accountable nationwide,” Patrisse Khan-Cullors, a senior fellow studying maternal mortality with MomsRising and a co-founder of Black Lives Matter, told Vox.

Although Garner's death wasn't a direct off-shoot of her pregnancy, what one clearly knows, for sure, is that childbirth had led to the onset of complications in her health. Esaw Snipes-Garner, Erica's mother, told the New York Times in December that her daughter’s first heart attack occurred shortly after giving birth to her second child in August. Doctors said the pregnancy strained Garner’s enlarged heart, a condition she was previously unaware of.

“What we’re seeing with Erica Garner is not just complications because of birth, but a larger conversation around her lack of access to health care,” Khan-Cullors was quoted as saying. “Black women don’t receive the health care we deserve from the moment we are born. And our mothers didn’t receive the health care they deserve. By the time that we get pregnant and go to have children, the [absence of] care that we should have received [has had an effect] and our bodies are aged beyond our years.”

The health crises is real and stress has a big role to play

It doesn't help to know that obesity, diabetes, cesarean births, and delayed prenatal care are some of the problems that black women deal with, also collectively act as a catalyst for maternal-related deaths.

And black women are most likely will be dealing with many of these issues. Coupled with civic and social evils like inadequate access to health care, poverty, harsher discipline in schools, and lower pay — all of which significantly impact the health of black women, combining together to lead to stress.

“It’s chronic stress that just happens all the time — there is never a period where there’s rest of it, it’s everywhere, it’s in the air, it’s just affecting everything,” Fleda Mask Jackson, an Atlanta researcher and member of the Black Mamas Matter Alliance, told ProPublica last year.

Not just expectant mothers, but the child too pays for the price. Black infants are twice as likely as white infants to die within the first year of their life.

Alas, what one fails to understand here is that clearly, stress aggravated by the prevalent racism and discrimination has an important role to play in killing black women.
And if the society itself has turned against them, à la police-incited violence, hostility in schools and workplace, there's no escaping the fact that black women are suffering under combined societal pressures.

Christen Smith, an associate professor of African and African diaspora studies and anthropology at the University of Texas at Austin, agrees with the above-mentioned theory and argues that police violence is particularly harmful to black women, who are forced to deal with the lingering trauma that could be killing them slowly.

“When we think of police lethality, we typically consider the immediate body count: The people that die from bullets and baton blows. The death toll gives the impression that black men are the disproportionate victims of police killings. But these numbers do not reveal the slow death that black women experience,” Smith wrote in a recent op-ed about Garner’s death and the long-term effects of police violence on black women.

People participate in a rally to protest the death of Walter Scott, who was killed by police in a shooting, outside City Hall on April 8, 2015 in North Charleston, South Carolina. (Getty)

In Smith's opinion, Garner’s case is a clear manifestation of the truth so obvious, yet ignored. In the years succeeding her father Eric Garner’s death, Erica gained widespread popularity as an activist fighting police misconduct.

A few months after her father’s death, she came under the spotlight for staging a 'die-in' on the same corner where he had been placed in a chokehold by NYPD officer Daniel Pantaleo. She fought hard to bring her father's story to attention and even started a foundation to safeguard his legacy and propagate a racial justice agenda.

In an interview three weeks before her death, Garner had revealed how stress was taking on her. “I’m struggling right now with the stress and everything... This thing, it beats you down. The system beats you down to where you can’t win,” she was quoted as saying.

As Smith further corroborated it, “the long-range trauma police brutality causes can be as deadly as a bullet." Clearly, the Garner family has been hit hard and the aftermath shall linger for generations to come.

People take part in a protest on July 8, 2016 in New York City.(Getty)

Conclusively, the real truth is that black women community will be subjected to racism and discrimination in one way or the other. The problem exists deep in our social tapestry and it cannot be easily unsewed at once.

Although #blacklivesmatter and other movements are playing an important role in bringing light to the ancient problem, activists argue that hospitals and doctors should step up to wash their eyes off racial tendencies and protect mothers, irrespective of what gender, race or background they hail from.

Watch the video here to understand the issue better:

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