I grew up on a rural peninsula that consisted of two counties and was serviced by one hospital. Because of its location, it wasn't exactly a magnet for top medical experts or fancy equipment. And it definitely wasn't a facility recognized for the latest medical advancements.
Instead, it built a reputation for misdiagnoses or completely missed diagnoses altogether, which became a running joke that our little hospital was only suitable for childbirth because that seemed to be a more "routine" medical procedure.
Only, it's anything but routine; it can often be rather fatal. Especially for our demographic.
Surprisingly, childbirth claims the lives of black women 3 to 4 times more than white women, regardless of socioeconomic or education status.
I learned that tidbit of information after I read about Serena Williams' life-threatening medical ordeal that happened the day after she gave birth to her daughter, Alexis Olympia, by emergency C-section.
Serena told Vogue magazine that she suddenly felt short of breath and automatically assumed she was suffering from blood clots again. (The Grand Slam goddess has experienced a pulmonary embolism in the past.) Between gasps, she told a nurse she needed a CT scan with contrast and a heparin drip, the drug used to thin a patient's blood.
But the doctor chose to perform an ultrasound of her legs instead. However, Serena persisted, arguing that the ultrasound wouldn't show anything, which it didn't. The CT scan ultimately revealed what Serena suspected all along: several small blood clots in her lungs.
"I was like, listen to Dr. Williams!" Serena recalled.
I can only imagine how that conversation would've gone at my hometown hospital, where the average residents may already be consumed by chronic stress resulting from minimal job opportunities and money, fractured relationships, pre-existing illnesses or lack of transportation to appointments, not to mention the what-the-hell-is-really-going-to-happen-during-labor-and-delivery thoughts. They may not be on point with regular doctor visits or aware of certain diseases that could be adversely affecting their health like diabetes and high blood pressure. They aren't always as vocal, either, because they don't want to come across as a difficult or know-it-all (or even a know-nothing-at-all!) patient so they're often sent home without further tests and proper treatment.
Also, it isn't unusual for medical staff to brush off a patient's complaints because perhaps the nurse thinks the patient is overreacting, self-diagnosing herself using WebMd – because who hasn't used the site to determine she definitely has walking pneumonia when, really, she has acid reflux – or confusing a side effect with a symptom. Serena's nurse initially brushed off her concerns thinking that she was confused by her pain medications. She was actually very aware and ultimately saved her own life.
I asked two medical professionals how we can be taken seriously as effective advocates of our health, especially those of us who have fewer resources than Serena and feel we often have little recourse.
"Don't allow [doctors] to just dismiss your concerns without them being looked into first," says Dr. Chad Patterson, a naturopathic physician. We don't have to quietly accept a vague response or the lack of one. If we have questions, don't be afraid to ask.
Dr. Patterson also advises that we educate ourselves on childbirth complications such as blood clots, hemorrhages, infections, pregnancy-induced hypertension – even gestational diabetes, which one of my friends developed during both of her pregnancies – or other difficulties stemming from an already-diagnosed disease.
"Stress increases everything," says registered nurse Kentoya Dickerson,* who also recommends doing some research to educate ourselves on possible diagnoses and expectations, which could help to alleviate the additional anxiety stemming from fear of the unknown. But she strongly suggests taking care of ourselves not only before, but also after, childbirth.
"It is important for all women to get proper prenatal care and follow up with the [medical doctor] after delivery," she says, especially when, as black women, we're already high-risk for heart disease and hypertension.
Kentoya, who has a history of hypertension herself, had her own post-pregnancy emergency similar to Serena's nightmare. Kentoya is also prone to blood clots so she was prescribed an anticoagulant but she didn't notice something was seriously wrong until a week later, after she was settling in at home:
"I experienced postpartum preeclampsia, which is very rare. I was discharged from the hospital and everything was fine. Almost a week later I noticed I was still very swollen. I couldn't fit my shoes. I was out of breath just trying to talk. I called my doctor and I was called in for an appointment. I was sent straight to the hospital and admitted. I was told my labs were off and if I didn't come in when I did, I was on the verge of having a seizure."
She attributes her own survival to knowing her body.
"It's very important for everyone to know their body and to report all changes to their physician," Kentoya says. "It took me knowing my body to know something wasn't right. Most [people] never even knew postpartum preeclampsia existed. I sure didn't. The treatment for preeclampsia is having the baby. Mine occurred a week after [my baby] was born."
And of course, there's the concern with covering copays and deductibles or finding ourselves pregnant while we're uninsured. But we shouldn't take shortcuts if we don't have health coverage. "I think there are free clinics that help with prenatal care," Kentoya says, "Not to mention everyone who is pregnant and low-income can get Medicaid."
As long as #45 doesn't mess with Medicaid, that is. But generally speaking, pregnant women can't be denied coverage.
Getting proper care before and after delivery and speaking up about our health concerns are definitely key pieces of advice to decreasing our chances of becoming a statistic. But more importantly is knowing our bodies so that we can immediately recognize when something is wrong and easily articulate that. "Patients are the experts on themselves," Dr. Patterson reminds us.
And we're always entitled to second and third opinions, as Kentoya adds, because being both diligent and vigilant when it comes to our health, regardless of our available resources, can greatly improve our likelihood of being here for our babies.
Editor's Note: *Some names were changed for anonymity.