Three-time Olympic champion Tori Bowie’s death from childbirth complications underscores the alarming reality that Black women are more likely to face the worst pregnancy-related outcomes in the U.S., regardless of socioeconomic status.
Bowie was found dead in her home in Winter Garden, Florida, in May. She was estimated to be eight months pregnant and in labor when she died, according to the medical examiner’s report released earlier this week. The possible complications included respiratory issues and eclampsia, multiple news outlets reported.
It’s a case similar to that of tennis star Serena Williams. Bowie won three medals, including the gold, in track and field at the 2016 Olympic Games in Rio de Janeiro. Both athletes were on the international stage, competing at the highest level before being hit with some of the most severe childbirth complications. In an essay last year, Williams described nearly dying during the birth of her daughter Olympia in 2017.
Despite advancements in medicine and technology, the racial gap in who is suffering the most severe consequences of childbirth is growing, data from the Centers for Disease Control and Prevention shows. Black women had the largest rate increase in maternal mortality between 2020 and 2021, which experts say was largely due to the coronavirus pandemic exacerbating medical racism already baked into the healthcare system.
In 2021, more than 360 Black women died of maternal health causes across the country, up from just over 290 in 2020 and more than 240 the year prior, according to the CDC.
Read more: Medical Racism’s Role in the Recent Spike in Maternal Mortality
“It’s difficult to wrap one’s head around why this continues to happen,” Dr. Garfield Clunie, an New York-based OB-GYN who treats high risk patients, said. Although the details of Bowie’s complications are not yet clear publically, he added, “it is well documented that Black women have a very difficult time being heard when they have concerns during their pregnancy.”
Knowing what to look for during pregnancy can help patients spot early signs of complications and advocate for themselves in doctors’ offices, experts say.
If you’re pregnant or considering having a baby soon, what signs and symptoms of complications should you look out for?
Elevated blood pressure readings, blurred or spotty vision, and a headache that does not go away with over-the-counter pain relievers could be signs of preeclampsia, a dangerous pregnancy complication that causes high blood pressure. The baby’s well-being can often be judged by its movement in the belly. Every baby has a unique pattern, Clunie said, so your second and third child will likely move differently than the first.
But anything that feels off or not quite right is worth getting checked out by your doctor, he said.
If you think something’s wrong, what should you do?
Clunie recommends that all pregnant people call their doctor to check their symptoms. They may not indicate anything is wrong, but it is good to be sure and get checked, said Clunie, president of the National Medical Association. And if you are not comfortable with your doctor or feel unheard, he recommends getting a second opinion. Listen to your body, he said, and speak to a trusted professional.
Still, Black women are often ignored or dismissed when they speak up, experts say. “It transcends our socioeconomic status. It transcends your education. It transcends your profession,” Clunie said. Patients should trust their bodies and find care providers willing to listen, he said.
Having additional advocates such as family members, friends, midwives, and doulas around before, during and after delivery can also help families experience a healthy pregnancy.
When do maternal deaths most often occur?
Bowie was found when sheriff deputies conducted a welfare check after she had reportedly not been seen or heard from for several days. It sheds light on what experts know about when a large percentage of maternal deaths occur, which is during the postpartum period.
“We know that over half of the maternal deaths happen after the time of delivery and a third are entirely out of the medical space,” Dr. Amanda P. Williams, a California OB-GYN, said. “We need to think about what we are doing in between when patients are in contact with the medical system.”
Williams is also the medical director at Mahmee, which provides pregnancy and postpartum support for people through messaging and virtual appointments between doctor’s visits. Having access to call centers and blood pressure cuffs at home is important, she said, but “if we’re not really listening, if we’re not really responding, there’s almost no point in having them.”
Most pregnancy-related deaths, which include those up to a year postpartum, are preventable. Severe bleeding and infections can contribute to complications. Some states across the country have made moves to expand Medicaid coverage from a few months postpartum to a full year after childbirth, given the rates of death.
“There is nothing wrong with Black people,” said Williams, about why these disparities persist. “This is about the downstream consequences and reverberations of systemic racism in our society, about whose voices matter, about who has access to care, and about how toxic stress is experienced within our bodies.”
Read more: Racism’s Relentless Toll on Black Health in America