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raceAhead: Serena Williams Almost Died In Childbirth

January 11, 2018, 6:45 PM UTC

Serena Williams, the greatest athlete of all time, nearly died after giving birth. Grand Slam wins and endorsement deals did not save her from the reality of being a black woman in America.

A recent Vogue profile of Williams with new husband Alexis Ohanian along for good measure, revealed how quickly her life hung in the balance after giving birth to their daughter, Alexis Olympia Ohanian, Jr. It’s an extraordinary story. Not only did Williams identify her own life-threatening symptoms, she successfully advocated for herself and saved her own life.

The next day, while recovering in the hospital, Serena suddenly felt short of breath. Because of her history of blood clots, and because she was off her daily anticoagulant regimen due to the recent surgery, she immediately assumed she was having another pulmonary embolism. (Serena lives in fear of blood clots.) 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!”

Her postpartum complications continued from there.

ProPublica has been running an extraordinary series on preventable postpartum deaths in the U.S. Between 700 and 900 women die each year, a number far higher than other wealthy nations. And that number appears to be rising. One study they cite suggests that some 60% of these deaths are preventable.

But black women fare far worse. Black mothers die at three times the rate of white mothers, and nothing – not wealth, fame, access to expert advice, education – seems to be improving our odds.

Poverty and inadequate health coverage may be a factor in some cases, but the issue is far more complex. And it’s systemic. Women who give birth at hospitals that serve black populations are more likely to experience serious complications and inadequate care than women who give birth in other facilities. Long embedded biases in the health care system mean that black women struggle to find providers who take their symptoms and pain seriously, explain their treatment options or simply regard them with respect.

From a recent ProPublica investigation:

Black expectant and new mothers frequently told us that doctors and nurses didn’t take their pain seriously — a phenomenon borne out by numerous studies that show pain is often undertreated in black patients for conditions from appendicitis to cancer. When Patrisse Cullors, a cofounder of the Black Lives Matters movement who has become an activist to improve black maternal care, had an emergency C-section in Los Angeles in March 2016, the surgeon “never explained what he was doing to me,” she said. The pain medication didn’t work: “My mother basically had to scream at the doctors to give me the proper pain meds.” When white people advocate for themselves or their family members, she said, providers “think they’re acting reasonably. When black people are advocating for our family members, we’re complaining, we’re being uppity, we don’t know what we’re talking about, we’re exaggerating.”

And the pervasive stress of racism and race-based trauma erodes the health of all people of color, but particularly women.

Serena knew her body, her risk factors and was comfortable speaking up on her own behalf — and she still nearly died. In a clear thinking country, statistics as grim as those surrounding black maternal mortality would be a cause for alarm and a call to action. The all-too-familiar silence is deafening.

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I feel like people think I'm mean. Really tough and really mean and really street. I believe that the other girls in the locker room will say 'Serena's really nice.' But Maria Sharapova, who might not talk to anybody, might be perceived by the public as nicer. Why is that? Because I'm black and so I look mean? That's the society we live in. That's life. They say African-Americans have to be twice as good, especially women. I'm perfectly OK with having to be twice as good.
Serena Williams