JACKSONVILLE, Fla – Black women are dying at rates two to three times higher than white women during pregnancy. Doctors say risk factors differ between white and Black pregnant women.
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Dr. Chandra Adams, owner of Full Circle Women’s Care, believes that the varied risk factors mean the medical industry needs to change.
Adams introduced News4JAX to one of her patients, who had dangerous red flags but was sent home from the hospital and nearly died.
Jessica Bazemore, who is African American, is an attorney and mom to Phillip, who’s almost 2 years old. He’s a busy boy, and this mommy is on it.
She was the same way with her pregnancy. Adams delivered her baby boy and provided prenatal care from the start.
“She had an induction scheduled, and we were going for a cesarean. And it was uncomplicated and uneventful,” Adams said.
Phillip was born weighing 6 pounds and 12 ounces and had a full head of hair -- a healthy baby boy delivered just as they planned. But after he made his way into the world, Adams noted something about Jessica.
“We saw that her blood pressures in the hospital after delivery were higher than they had been during pregnancy. They weren’t technically considered high, but they were higher for her,” Adams said.
Because of that, Jessica was given a list of instructions.
“If you feel this way or you feel that way, it is likely to be (your) blood pressure’s going up,” said Adams.
One of those warning signs was difficulty breathing, which Jessica experienced even before leaving the hospital.
“I do remember telling the nurse like, ‘Hey, I’m waking up choking. I’m still swollen. I don’t know what’s going on,’ and she told me that I probably just had sleep apnea and to follow up with my primary care,” Jessica said.
She accepted that answer, but when she got home, her symptoms only got worse.
“I remember telling my fiancé, ‘Hey, can you just pick up some Mucinex?’ I’m having trouble breathing,’” Jessica said.
He bought the medicine but eventually took her to the emergency room. Adams said that decision saved Jessica’s life.
“In about 3 to 5 minutes, I was in the ICU,” Jessica said. “I do remember crying because I just gave birth and they were taking me away from my baby.”
Adams said Jessica was in heart failure. Her blood pressure was through the roof. She had severe postpartum pre-eclampsia, which not everyone knows can occur within the first 14 days after delivery.
Jessica now knows exactly what an emergency feels like and, in her case, knowledge is truly empowering.
“I’m actually ready to give him a sibling because this is such an enjoyable experience,” she said. “So now having him, it was all worth it. And I just know what to look out for next time.”
Adams said blood pressure is especially important to watch for expectant moms who are African American.
“African American women are more predisposed to have high blood pressure outside of pregnancy -- and so pregnancy is a physiologic stress,” Adams explained. “Cardiovascularly it places more stress on the circulatory system and the cardiovascular system. So someone who has a baseline risk, and you add physiologic stress, they have a higher risk for the poor outcomes.”
Jessica never had high blood pressure during her pregnancy, but the higher reading after she delivered was a red flag for Adams.
“These are the stories that we’re hearing,” Adams said. “‘She was fine when she went home, and then they found her dead.’ Because what happens is the blood pressures get so high that the fluid backs up into the lungs and the moms, essentially, drown and suffocate.”
Since Black women are more at risk for pre-eclampsia, they’re more at risk for dying when things go wrong. Adams believes a change in the way care is delivered for all women will help.
“There are protocols for surgical care and infection prevention. But the protocols for maternity and hypertension still leave something to be desired,” Adams said.
Adams believes one protocol change should be that when a patient’s blood pressure spikes above 140/90 during or after pregnancy, only an OB hospitalist or the OB on-call should be able to discharge the patient.
Adams explained that a joint commission that sets guidelines has already instituted protocol changes to track postpartum hemorrhage, early intervention and massive transfusion protocols -- and that has saved lives.
“But really what it took was this social pressure of this is happening,” Adams said. “Let’s go back and figure out why. Oh, we know why. Now let’s figure out how to prevent it.”