Tori Bowie – What must we do?
by Ngozi Osuagwu, MD | June 19th, 2023
I was covering the resident OB/GYN clinic when one of the residents commented, “You know that Olympian who died a few weeks ago, the autopsy is back; she died of eclampsia.” I immediately googled it and found that it was Tori Bowie. I remember she was the anchor leg in the 4 x 100 mm when the relay took Gold in Rio. She was only 32 years old.
It was almost three years ago I was writing about Dr. Chaniece Wallace. She was a 30-year-old black pediatric chief resident who lost her life four days after giving birth to a baby girl. Dr. Wallace developed preeclampsia (high blood pressure during pregnancy) and had a cesarean section. Most of the time, death related to preeclampsia is preventable. Eclampsia is a severe form of preeclampsia associated with seizures.
I now understand why a pregnant patient asked me the following question- are you aware of the statistics for pregnancy deaths among black women? I am convinced she read Protecting Your Birth: A Guide for Black Mothers. Black women are at least 2.5 times as likely to die in childbirth than white women, with one estimate showing rates among college-educated Black women are 5.2 times that of white women. My patient wanted to ensure she would not be part of an unsettling statistic.
Erica Chidi and Dr. Erica Cahill, authors of the guide, describe four steps:
Step 1: Acknowledge Race and Racism In the Room – When black women are dying more than any other ethnic group in the United States, it cannot be ignored. Hopefully, you will be comfortable discussing this issue with your provider. The guide provides you with information on how to have this conversation.
Step 2: Create a Care Plan Anticipating That Racism May Impact Pregnancy – Some conditions are common in black women – hypertension, preeclampsia, and preterm delivery. It is important to understand the warning signs. Do not be afraid to ask questions. Learn what to do if you are not feeling well.
Step 3: Identify How Racism May Impact Labor – Non-Hispanic Black women have a higher primary (first-time) cesarean delivery rate. Taking a birthing class, especially for first-time mothers, may be helpful. Having a support person like a doula may be beneficial.
Step 4: Identify How Racism May Impact Postpartum – Up to 45 percent of maternal deaths happen in the weeks after the delivery. If you are considered high-risk during your pregnancy, you should see your healthcare provider at least within ten days of your delivery. Waiting six weeks can be too late. Do not be afraid to contact your provider if you have any concerns.
Please take your time to read the guide whether or not you are planning to become pregnant. You can apply some of the information to other medical encounters. Share the information with your healthcare provider that takes care of a diverse group of women. Share the information with your inner circle. We must work together to ensure that another woman does not die during childbirth.
Another great resource can be found at Every Mother Counts, where they provide a Black Maternal Health Resource List.
Ngozi,
I read the blogs with enthusiasm knowing I will learn something or refresh what I already knew. This is a very sad story but we must learn from it and commit to recognizing these racial disparities and applying the knowledge as we care for our patients. I particularly discuss racial data with my patients of color with high blood pressure.
Thanks for your dedication to the health of your sisters.
Maureen
I appreciate your commitment as a health care provider acknowledging racial disparities exist and having frank conversations with your patients. It is so important that all our patients know we want them to have the best health outcomes. Thank you.