Bowie was Eight Months Pregnant, and Died Due to Complications from Childbirth

Black maternal mortality in America is finally getting the attention it so urgently needs. People are acknowledging the problem, discussing it, and hopefully formulating ways to flip the script on this grim health disparity.

Sadly, the reason the issue recently recaptured the conscience of the public is due to the tragic, high-profile case of African American Olympic track and field medalist, Tori Bowie. Bowie, 32, was found deceased in her home in Winter Garden, Florida, on May 2, and, just over a month ago, the Orange County Medical Examiner’s findings revealed her cause of death as complications from childbirth.

In a lot of minds, the concept of a woman dying in childbirth is a relic of times long past—something that may have been a concern during pioneer days if/when a doctor needed to travel a great distance to the home of a woman giving birth. Or maybe it’s a concern often relegated to underdeveloped countries—not one that impacts industrialized nations like the U.S., where top-notch medical care is available.

But when we compare the United States to other “developed” nations, you might be surprised to discover how we stack up. In looking at the numbers, The Commonwealth Fund—a non-profit foundation that focuses on improving the health care system and ensuring it serves all equitably, found that between 2018 and 2020, the U.S. had the highest maternal mortality rate in the world when compared to other industrialized countries. The Netherlands, which scored highest in protecting its mothers, had a maternal mortality rate of 1.2 deaths for every 100,000 births. In contrast, the US had the highest maternal mortality rate, with 23.8 deaths for every 100,000 births.

This gap is alarming enough on its face, but when Commonwealth drilled down by race, the numbers were even more troubling. For Black women in America, the maternal mortality rate was a whopping 55.3%. Even when solely compared to numbers within the U.S., Black women have a maternal mortality rate that’s more than twice the national average and almost three times higher than the rate for white women.

In an essay for Time magazine earlier this month, Olympic superstar Allyson Felix remembered her former teammate, with whom she ran the 4 x 100 relay during the 2016 Rio Olympics. She also reflected on her own pregnancy and the frightening development of preeclampsia, which is one of the factors believed to have precipitated Bowie’s death.

In her Time piece, Felix says, “I developed preeclampsia during my pregnancy with my daughter Camryn, who was born in November 2018. The doctors sent me to the hospital where I would deliver Camryn during an emergency C-section, at 32 weeks. I was unsure if I was going to make it. If I was ever going to hold my precious daughter.”

At Ronald McDonald House New York, we are proud to be among those seeking solutions by creating programs to redress the dire crisis in maternal health that has resulted in too many preventable deaths across the city’s five boroughs.

Maternal mortality for Black woman in New York is worse than the national average. In its tracking of pregnancy-related deaths through the full year after the pregnancy ends, the New York City Health Department noted that this crisis is “especially severe” for African American women here in New York. In fact, its findings state that “the pregnancy-related mortality ratio for Black women in NYC is more than nine times that of white women.”

But before we talk about ways to address this disparity and the problem of maternal mortality overall, let’s look at the causes.

In her book “Under The Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation,” author Linda Villarosa delves into racial health disparities, and, along the way, dispels myths and misconceptions as to why life expectancy for African Americans falls so far below that of white Americans.

She writes: “At every stage of life, Blacks have poorer health outcomes than whites, and, in most cases, than other ethnic groups. Black babies are more than twice as likely as white babies to die at birth or in the first year of life… African Americans have elevated death rates from conditions such as diabetes, stroke, and heart disease that among whites are found more commonly at older ages. In a phrase, African Americans “live sicker and die quicker…”

Villarosa acknowledges that for years, prevailing theories have laid the blame for this disparity squarely on poverty. But over her decades as a journalist writing about Black health in America, she’s come to realize that the problem runs much deeper. She notes: “poverty is not the sole factor in who gets sick and who doesn’t, in who survives and who passes away; it just makes the situation that much worse. Even when income, education, and access to health care are matched, African Americans remain disadvantaged and racial disparities in health cut lives short. College-educated Black mothers, for example, are more likely to die, almost die, or lose their babies than white mothers who haven’t finished high school.”

The author points to “living in communities that have been harmed by long-standing racial discrimination,” “a deeply rooted and dangerous racial bias in our health-care system,” and “the insidious consequences of present-day racism” as determinants that fuel these inequities. Villarosa notes that “These factors create physical vulnerability and systemic disadvantages that education, income, and access to health care cannot erase.”

Tennis great Serena Williams’ own story seems to underscore Villarosa’s thesis. In an Elle magazine essay last year, Williams recounted having to insist on tests to find the cause of her pain after having her concerns dismissed by hospital staff following the birth of her daughter in 2017. She’d had life-threatening blood clots in her lungs several years earlier and was worried that it was happening again. Only after she demanded tests did staff acquiesce and discover she did indeed have blood clots and needed immediate surgical intervention.

Williams wrote in the essay: “Being heard and appropriately treated was the difference between life or death for me; I know [Black maternal mortality] statistics would be different if the medical establishment listened to every Black woman’s experience.”

I’ve known Linda Villarosa for years, and we share a belief that addressing and eradicating healthcare inequities in the U.S. is a major imperative, so it was gratifying to see her book named a 2023 Pulitzer finalist in May. “Under The Skin” was released in paperback last month and is a must read for understanding the racial health gap and the social drivers of health that contribute to Black maternal mortality.

At Ronald McDonald House New York, we are working to move the needle on this pressing societal fail. We’ve established a maternal health program that offers pregnant women with maternal health risks?a “home away from home” that’s in proximity to major city hospitals, with a menu of support services to help them and their babies toward a successful delivery and a speedy recovery.

And by partnering with13 hospitals across the City, we extend our support services into the community to women both before and after their delivery, and we can identify women who have high-risk pregnancies and may be candidates for resident care at Ronald McDonald House New York.

?