By Dave Fountinelle | dave@fresnoflyer.com
When Serena Williams gave birth to her daughter Olympia in 2018, she never expected a routine C-section delivery to result in a series of complications that would almost cost her life. Williams, the most famous Black female athlete in the world, almost died because no one listened to her. Her concerns about her own health were ignored or dismissed by her nurses and doctors. They exposed a severe and systemic problem of racial bias in the American healthcare system. And it is a problem all too familiar to women of color, especially those in poor and underserved communities.
Racism and discrimination in the healthcare system have been a well-documented and long-standing issue for minority pregnant women, especially Black women. For example, a 1992 New England Journal of Medicine report found that a college-educated Black woman had a significantly higher chance of her baby dying within the first year after birth than a white woman with an 8th grade education. In addition, they compiled 174 different studies on how race affected both the biology of expecting mothers and the quality of healthcare they received. The results of these studies were that there was a direct and provable correlation between race and the quality of healthcare pregnant women receive in America. Further, this disparity was pervasive throughout the healthcare system, affecting access, diagnosis, treatment, and aftercare.
The United States is one of only 13 countries where the death rate is worse today than it was 25 years ago. Between 700 and 900 women die each year from problems related to pregnancy, childbirth, or postnatal complications within a year of delivery. And the disproportion between Black and white mothers and their babies is shocking. Black infants are more than twice as likely to die during birth or within their first year than white babies. A disparity even worse than it was back in 1850 – 16 years before the end of slavery.
Sabrina Kelley has made it her mission to change those statistics. The daughter of a Black teen mother, born low-weight, Kelley has a strong personal connection to the struggle Black women face in getting adequate pre and postnatal care. As a result, Kelley founded the Black Maternal Wellness Innovation Lab (BMWIL) to address the Black premature birth epidemic in Fresno County, which has the second-highest number of premature births in California.
“The reality is, Black women don’t feel heard or seen by healthcare providers,” Kelley says. “Too often our concerns are ignored, or the care we receive is inadequate.”
Serena Williams’ harrowing experience is the unfortunate and far too common reality for many women of color in America today. It is estimated that between 50,000 and 70,000 women each year deal with dangerous or life-threatening complications from pregnancy. And Black women, in particular, are 3 to 4 times more likely to die from pregnancy-related health complications than white women. Having undergone treatment for pulmonary embolism in 2011, Williams was familiar with its warning signs. So, when she began experiencing shortness of breath, she quickly alerted a nurse. However, as she related later in an interview with Vogue, the response she received was not what she expected.
“She walked out of the hospital room so her mother wouldn’t worry and told the nearest nurse, between gasps, that she needed a CT scan with contrast and IV heparin (a blood thinner) right away. The nurse thought her pain medicine might be making her confused. But Serena insisted, and soon enough, a doctor was performing an ultrasound of her legs. “I was like, a Doppler? I told you, I need a CT scan and a heparin drip,” she remembers telling the team. The ultrasound revealed nothing, so they sent her for the CT, and sure enough, several small blood clots had settled in her lungs. Minutes later, she was on the drip. “I was like, listen to Dr. Williams!” (Vogue, 2018)
Williams continued to have health problems after that. Her severe coughing from the embolism caused her C-section wound to rupture. When she went in for surgery, doctors found a hematoma filling her abdomen caused by the blood thinners. She had a filter placed in a major vein to prevent blood clots from traveling to her lungs. When she finally came home, she was on bed rest for six weeks.
Stories like Willams’ are appallingly common among Black women of all socioeconomic levels. However, the outcomes are often tragic for those without the benefit of Williams’ wealth and profile. Kelley founded BMWIL to give a voice to those mothers who don’t have the platform or resources to make themselves heard.
BMWIL uses Human-centered design (HCD) to train, develop, and empower Birth Justice Advocates to help educate and support Black and minority mothers in underserved areas of Fresno. Particularly in the 93706 zip code, which has one of the highest preterm birth rates in the nation. These Birth Justice Advocates provide a voice for the voiceless, lobbying on their behalf with state and local officials, as well as healthcare providers.
“We provide our Birth Justice Advocates with knowledge, talking points, and the tools to communicate effectively with elected officials and health providers,” Kelley explains. “Sharing resources, making connections, and building a voice to bring awareness to these serious issues affecting all women, and particularly Black women.”
Social media has been a powerful and effective tool for BMWIL to raise awareness and connect and share information with expecting mothers in Fresno County.
“We created the #areyoulisteningtoher campaign to help elevate these challenges that Black women in particular face when they try to access the healthcare system and providers,” Kelley explains. “The focus is on continuing these conversations in the black community and looping back to social media in preparation for the launch of Black Maternal Health Week.”
Black Maternal Health Week runs from April 11th to the 17th. As part of its activities during the week, BMWIL plans to facilitate a roundtable discussion simulcast live on social media and YouTube. They have also partnered with UCSF graduates Tamera Moore and Nahima Shaffer to produce “In Our Bodies.” The video highlights the problem of unconscious bias and racial discrimination in healthcare from women who’ve experienced it first-hand.
Additionally, BMWIL has launched #thepath to promote body awareness and self-care for teens and preteens. The intent is to teach young women how to take care of themselves and choose when to become sexually active instead of feeling pressured into it. Educating young women about the options available to them, including Planned Parenthood, empowers them to choose motherhood on their terms and make the best decisions for their health and the health of their baby. Additionally, to hold medical providers accountable and encourage them to listen to women’s feedback and hear their concerns.
And while the primary focus of BMWIL is advocating on behalf of Black women, particularly in the 93706 zip code, Kelley believes that theirs is a message that can empower all women.
“It’s important to highlight collaborative innovation between women of all ethnicities,” Kelley says. “We live in an area with high ethnocentric concentration, so advocating for all women helps all women, not just one particular ethnic group. As we prepare to celebrate National Women’s Day, it’s essential to talk about the collective power of all women and what can be accomplished when all women get together and make our voices heard.”
For more information about the Black Maternal Wellness Innovation Lab, follow them on facebook at facebook.com/BMWILab, or Instagram @bmwilab.