American Black women face disproportionately high rates of maternal mortality

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• Geoff Bennett:

  The sudden death of a Olympic sprinter Tori Bowie at age 32 sent shockwaves around the world. Once known as the world's fastest woman, Bowie died at her Florida home from complications of childbirth.

  The tragedy is resonating deeply with Black women, who are at higher risk of dying while pregnant.

  William Brangham looks at the ongoing problems of maternal mortality in the Black community.

• William Brangham:

  Geoff, the idea that Tori Bowie, a young elite athlete eight months pregnant, could go into labor and then die stunned so many.

  But this problem is more common than many people realize. And it is particularly bad for Black women. The CDC estimates that, in 2021, the maternal mortality rate among Black women was nearly 70 deaths for every 100,000 live births. That is 2.6 times the rate for white women, regardless of income or education.

  Dr. Amanda Williams is the clinical adviser at the California Maternal Quality Care Collaborative, and an adjunct professor at Stanford University's School of Medicine. Her work is dedicated to protecting Black mothers. And she joins us now.

  Dr. Williams, so good to have you on the "NewsHour."

  I hope you don't mind me mentioning this, but your own personal story dovetails with Tori Bowie's. You were a top athlete, track athlete. You were a qualifier for the 1996 Olympics. You too had preeclampsia with your first child.

  When you first heard of Tori Bowie's death, that — it just must have sat with you in a particularly awful way.

• Dr. Amanda Williams, California Maternal Quality Care Collaborative:

  Absolutely. It was as if the mirror was shining back at me.

  And I know that, were it not that I was very fortunate to be in UCSF Medical Center and have access to such tremendous care, that that could have been me as well.

• William Brangham:

  Before we get into the racial disparities in this country, I mean, America's overall maternal mortality rate is awful compared to other similar countries.

  Can you help us understand why that is?

• Dr. Amanda Williams:

  This is a way where American exceptionalism is not in our favor.

  We are truly the worst of all industrialized countries. And a lot of it comes down to the way that our care is given. For example, most other countries, low-risk care is given by midwives, whereas, in the United States, you have low-risk care being given by high-risk doctors, who then and that are not giving patients the opportunity to have the physiologic birth that they might be able to.

  We have lots of unnecessary C-sections. We don't have psychosocial supports. We don't have easy access to things like mental health support, nutrition coaching. There's so many places where we could be better in the United States.

• William Brangham:

  And so, when you think of all of those factors, and then look at the racial disparities within the United States, are those all complicit in that as well? Are there other things as well?

• Dr. Amanda Williams:

  Well, the thing that's missing that is so Germane to Black and indigenous birthing people is the history of systemic racism, and how racism has been infused into American medicine.

  And when we look at the data — and some of it does come out of Stanford — around both education and income not correcting for the differences in Black birthing people's mortality rates, lots of times, we think, our education will save us, our income will save us.

  But I couldn't have been more educationally privileged. Serena Williams could not be more financially privileged. And yet these negative birthing outcomes are still happening.

• William Brangham:

  Right. It is so striking when Serena Williams, as you mentioned, who had many of these similar complications, and is a woman that seemingly has unlimited funds and access to the greatest doctors anywhere on the planet at her beck and call, it is a such a striking indictment of health care in this country.

  The committee that you're a part of at Stanford found that 80 percent of California's maternal deaths are preventable. How is that? Eighty percent.

• Dr. Amanda Williams:

  It's really stunning.

  And I have to admit, it was a transformative life moment being in those charts of patients and looking so deeply at the records, at the operation nodes, at the neighborhoods that they're coming out of. And many of them, it is stunning, really were preventable, whether it was they went into labor, and they were in a place where they couldn't get easy access to the hospital in what we call maternity deserts, as the March of Dimes has designated them.

  Or it could have been that the patient's complaints weren't being listened to. Patient is saying, I have pain, I have pain, or my bleeding is more, and being shushed aside and saying, there there, everything is fine, or lab results not being recognized in a timely fashion.

  It really is stunning the way that these preventable deaths are showing up.

• William Brangham:

  So, give us some counsel here. Imagine that there are pregnant women out there listening to you.

  What is some advice that they ought to be thinking about as they think about how to go about having the healthiest pregnancy for themselves and their child?

• Dr. Amanda Williams:

  I think some of the top pieces of advice that I would give is, number one, never interact with the medical system alone.

  Doctors, nurses, great hearts, wonderful people — I have spent my entire career being an OB-GYN physician. But they're super busy. They get distracted easily. And they are constantly, in their head, making connections. That is how we make diagnoses. Yet it's also how we make assumptions. And those assumptions can be wrong.

  So have someone with you, whether it's your sister, your mother, your partner, your doula, to be an advocate for you. Also, I highly recommend getting culturally concordant care. So, we know there's plenty of data to support that it's not just nice to have someone from a similar background who knows people from your background well. It actually is associated with safer birth outcomes.

  And then, finally, get your provider used to hearing your voice. So always come with questions. Always have a few things written down ahead of time, so that they get used to you being an advocate. And then, finally, I would say wraparound services, so to think about the things that probably should be part of traditional care, but aren't, things like doula support, things like lactation support, mental health, nutrition, those pieces of the puzzle that are often forgotten, yet are an important part of people's well-being and safety.

• William Brangham:

  All right, Dr. Amanda Williams of Stanford University, thank you so much for being here.

• Dr. Amanda Williams:

  Thank you so much. I wish this issue wasn't going on, but I'm going to use every platform to advocate for Black birthing people.