Joquita Hill’s heart sank when she heard the news about the death of three-time Olympic champion Tori Bowie from childbirth complications.
“I kept thinking, ‘this could have been me, this could have been me,’” said Hill of Atlanta, on the verge of tears. She nearly died from complications after giving birth to her daughter, Lyric, who is now 4.
Bowie’s recent death is drawing attention to an alarming reality – that Black women, regardless of wealth or social standing, are far more likely to die during pregnancy or delivery than any other race.
In Georgia, the Centers for Disease Control and Prevention reports Black mothers died at a rate more than twice the rate for white mothers for 2018 to 2021. Nationally, the maternal mortality rate for Black women was nearly three times the rate for white women. To address that gap, two different efforts are about to get underway in the state to help Black women and families who are preparing for or have recently given birth get the best medical care.
Bowie, who won three medals at the 2016 Rio de Janeiro Games, was found dead inside her Florida home on May 2. According to the Associated Press, a medical examiner estimated Bowie was eight months pregnant and appeared to be undergoing labor when she died alone inside her home. Her baby did not survive.
The examiner reported the 32-year-old showed signs of eclampsia: an emergency condition involving high blood pressure for pregnant women that can involve seizures and coma, and is a major cause of maternal death around the world.
Hill, who is Black, said she suffered from postpartum preeclampsia days after giving birth. Her blood pressure soared to dangerously high levels and she lost so much blood that by the time she arrived at the hospital, she needed a blood transfusion. In addition, part of the placenta was left inside her womb after the birth — a situation that can turn life-threatening if untreated.
“I always felt like my care was rushed, all the time, like no one had enough time for me,” she said, still visibly shaken by the memory of her doctor visits and her time at the hospital delivering her baby.
Simply being pregnant poses significant short-term and long-term risks to health for all races. But data collected on maternal mortality show stark racial divides. The CDC defines maternal mortality as deaths that occur during pregnancy or in the months following pregnancy that are due to a condition caused or aggravated by pregnancy. A staggering number of maternal deaths in the U.S. were found to be preventable — 84% of cases were due to preventable causes, according to a CDC report.
Advocates for patients have long maintained that one of the biggest lost opportunities to save a life happens when doctors, nurses, or aides don’t take patients’ complaints seriously. Research, including a study by the University of Virginia, suggests that ignoring valid patient complaints especially harms Black patients.
On Thursday, an Atlanta-based non-profit helped kick off a city-wide campaign in Atlanta for an app where Black parents can post Yelp-like reviews of doctors and hospitals. Sheltering Arms, which provides family support services at 13 locations in metro Atlanta, hopes a new app will let Black patients inform each other how they were cared for.
Credit: NATRICE MILLER
Credit: NATRICE MILLER
“What’s happening is unacceptable,” said Kimberly Seals Allers, a former senior editor at Essence and maternal health advocate. “We believe in the power of publicly shared ratings and reviews to inform and protect Black birthing people and to drive accountability and transparency within Atlanta’s health system.”
Allers, who is based in New York, said she developed the new app, which is being set up across the country. After six months in Atlanta, her team will publicly share the results and ratings. Low-performing hospitals will be invited to engage with her non-profit to work on an improvement plan based on the feedback and reviews. She said they are already working with hospitals in several other cities including New York and Philadelphia on improvement plans.
The idea for the app came from her own birthing experience in New York City 20 years ago.
“Thankfully I am here to share it,” she said. “But I felt completely disrespected. Everything I read in reviews and best hospital lists about what was supposed to be the standard practice of care, I had to fight for. I spent some time blaming myself and then I began to hear other people’s stories.”
Barriers to care
Nationally, the maternal mortality rate for all races has increased sharply in recent years.
The National Center for Health Statistics reported more than 32 deaths per 100,000 live births for 2021, the most recent data available. That’s up from a rate of 17 deaths per 100,000 live births in 2018.
Based on the CDC’s combined data for the years 2018 to 2021, Georgia had the seventh-highest maternal mortality rate in the nation – around 34 per 100,000 births.
For the first time since the pandemic, the state Department of Public Health is expected to soon release a major report on maternal mortality in Georgia. A brief report was released in March by Georgia’s Maternal Mortality Review Committee and summarized the top six causes of maternal mortality in the state. The causes were, in order: hemorrhage; mental health conditions; cardiomyopathy; cardiovascular or coronary conditions; embolism (blood clot); and preeclampsia or eclampsia.
The committee also determined that of the 78 maternal deaths recorded in Georgia from 2018 to 2020 — all but two were preventable.
Access to care can often be especially difficult in Georgia. According to estimates by the Georgia Alliance of Community Hospitals, 78 of the 159 counties in Georgia have no obstetrician or gynecologist; 63 have no pediatrician.
Credit: NATRICE MILLER
Credit: NATRICE MILLER
Georgia to visit new parents
But advocates also see hope. The Georgia General Assembly voted to extend Medicaid health insurance coverage for poor mothers to a full year after giving birth, up from 6 months. With 54% of all births in Georgia covered by Medicaid, the additional months of coverage are expected to make a difference.
And a new home visit pilot program, which was allocated $1.7 million in the state budget for the upcoming fiscal year, is expected to begin in July with five nurses and six community health workers, according to the Georgia Department of Public Health, which will operate the program.
The home-visiting program is meant to promote healthy pregnancies, improve parenting skills and reduce child abuse and neglect. Support for pregnant women includes blood-pressure monitoring, glucose screenings and fetal heart-rate monitoring. After-delivery support includes clinical services and screening for postpartum depression.
Women eligible for home visits include those at high risk of pregnancy complications, those with HIV and other chronic health conditions.
The home visits for at-risk and underserved pregnant women, especially those who live in rural areas and lack access to obstetrical care, would be located mostly in the northern and southern corners of the state and in the counties of Coffee, Atkinson, Clinch, Jeff Davis, Evans, Candler, Toombs, Bulloch, Habersham, Stephens, Franklin, Hart, and Banks.
The home visiting program was identified as a key priority for the March of Dimes, which recently scored Georgia with an “F” for its worsening record of maternal and infant mortality.
Meanwhile, back at Sheltering Arms, Tiffani Terry, a 27-year-old mom to two children, ages 1 and 5, was eager to give a review to her OB/GYN — a glowing one at that.
“My doctor made me feel very comfortable and he was there for the birth of both of my babies,” she said. “He was there explaining everything and it ended up being a very positive experience.”
