The Daily - A Life-or-Death Crisis for Black Mothers

Episode Date: May 11, 2018

Black mothers and infants in the United States are far more likely to die from pregnancy-related causes than their white counterparts. The disparity is tied intrinsically to the lived experience of being a black woman in America. Guests: Linda Villarosa, a contributing writer for The New York Times Magazine, and Simone Landrum, a young mother in New Orleans. For more information on today’s episode, visit nytimes.com/thedaily.

From The New York Times, I'm Michael Barbaro. This is The Daily. Today, childbirth is killing Black mothers and their babies at staggeringly high rates in the U.S. Why their deaths have everything to do with the lived experience of being a Black woman in America. with the lived experience of being a Black woman in America. It's Friday, May 11th.

And baby was moving good on the ultrasound and the scan? He's big because you can't see his face no more, so you can tell he's big. Is he head down? Yep. Good, yay! Yep, he's big. Is he head down? Yep. Good, yay! Yep, he's been head down for a while now. So he stay knocking.

You can see him moving up and down in my stomach now, so he's big. Is that reassuring for you when you see him moving and stuff? Yeah, it makes me happy because I know he's okay. Yeah. Yeah, make me happy because I know you're okay. Yeah. So Simone Landrum is a young woman living in New Orleans who was pregnant. So your blood pressure does gradually increase a little bit during pregnancy, and that's normal. And I met her with her doula.

I know. We're watching out for that big increase. Yeah, you know, like, I'm just like, when I see him, I'm like, is this okay? She's like, it's okay. It's more than okay. I'm just like, huh. She's only 23 years old, has a great, upbeat personality, but she's also clearly very nervous about this pregnancy. Linda Villarosa is a contributing writer to The Times magazine. You know me. my mind thinking. Yeah. Like she would say, I'm really nervous.

I don't want to die having a baby. I don't want my baby to die. Just say like if you have a flashback in your mind, like in this like, I remember last time, seeing like everything was okay, but I was sick. I remember that. She just was afraid that she wasn't going to make it because of what happened last time seeing like everything was okay, but I was sicker. I remember that. She just was afraid that she wasn't going to make it because of what happened last time. I found out she was a girl on my grandmother's birthday, and that's September the 6th.

She calls her grandmother Muma, and Mooma had died recently. And I found out that there was a girl on her birthday. Oh, beautiful. Yeah. So she thought it was kind of divine order that she was having a girl. She wanted to teach her daughter how to sing. She loves music, so she had already decided to name her Harmony. And then you have Dylan, who's turning seven.

And what's your other son's name? His name's Kayden. Kayden. He's four. Okay. Yes. But then during this pregnancy, she noticed something different. Okay. With that pregnancy, I was sick and my head used to hurt so bad, like so bad. It was like shocking pains in my head. It felt like, like it hurted. So the headaches were blinding so much that she was working as a waitress and had to leave that job. And so she talked to her doctor about the headaches, and he kept telling her, well, you know, just take some Tylenol.

And she complained again, the headaches are quite bad. And he said, just take more Tylenol. And she wasn't comfortable with that, but she wasn't sure what else to do. take more Tylenol. And she wasn't comfortable with that, but she wasn't sure what else to do. So then what happened when you got closer to your due date? When I got closer to my due date, I remember one time I went in for a regular visit. It's November, and Simone is noticing that she's really not feeling that well. She's having swelling. She's still having those headaches that Tylenol is not really helping. So she goes to her regular prenatal

visit with a lot of things to talk about. And my blood pressure was high. And when it was high, he told me to lie back. And he was like, just lie back until your blood pressure go down, and we're going to check it again. High blood pressure is always dangerous, but especially during pregnancy, because it can lead to hemorrhaging. It can also lead to an abruption, which means that the placenta detaches from the uterine wall. And that's very bad for the baby because the baby can't get the nutrients he or she needs. Bad for the baby, bad for the mother. It's life-threatening for both. I was just telling him I didn't feel good. And I remember my baby shower being like a day or two

after. I think it was the next day. But then he gave me an ultimatum. He was like, I was like, my baby shower next day. And he was going out of town. He had a vacation. She was really freaked out. And she said, what should I do? And the doctor said to her, well, you know, you could go up to labor and delivery now and we could deliver the baby. And she said, well, wait, isn't it too early? And he just said, well, I'm going to be out of town. And so I this is when I could do it. Or your other choice is just to sit back, calm down and try to get your blood pressure down.

I don't know. I'm not a doctor. You know, I'm just knowing that, you know, I'm having high blood pressure in my body, a little achy. I'm thinking that I'm, you know, probably about to go into labor. But she was also afraid, and she was listening to him because she thought he was a good doctor. And so when he checked it again, I assumed that it was lower. He told me to just go home. And he told my baby father, he said, just sit down and just make sure she don't really do much. She don't move much, like basically to go on bed rest.

So she thought, OK, everything's fine again. So tell me how it happened. Like what happened? OK, I was laying down, wasn't feeling good, like, all day. Like, felt like I couldn't even really get up and walk. I thought I was just in labor. So I'm like, let me just head shit out at home. It's four days later, and Simone has gotten much sicker.

She's very tired. She's got bone-weary fatigue. She can hardly get out of bed. I finally was ready to go to the hospital, and I was just like, ooh, just come on. I felt the urge. I finally was ready to go to the hospital and I was just like, oh, just come on. I felt the urge. I'm like, can you please just come on? She was in the car. I felt a splash, but I thought it was my water broke. When I got out the car, I seen it was blood like on the seat. And so she ended up actually getting in an ambulance and going. It was an emergency situation. And once I got in the ambulance, I remember they had made me lie back. And I remember I felt blood coming down. Like it was more blood. It's blood. It's just coming. Like,

and it just kept coming. And I felt like they were just taking their time. Like they was not moving fast at all. And when I got in there they were sitting back and then they basically checked to see if she was breathing and stuff like that and when they did check for that it was nothing because i kept saying is she okay is she okay and everybody was quiet you know in the room and i'm like she all right, you know, in the room. And I'm like, she all right, right? You know, like, well, I don't hear nothing. And then they finally told me, like, the room was so silent. Like, I've never heard nothing be that silent in my life. And then what was your condition?

Like, what you probably know now. They told me I had preeclampsia, and it was an abruption, and they had to give me five blood packets and platelets. So, yeah. Sounds like you almost... Exiled. Yeah. What exactly had gone wrong with this pregnancy?

So preeclampsia is simply high blood pressure during pregnancy. And the symptoms were obvious. The swelling, the high blood pressure, as well as the headaches. But it was ignored. And it led to an abruption that led to hemorrhage and so the hemorrhage almost killed her and actually did kill her baby and i remember like i'll be back with y'all sister you know and they get so happy they're so happy now and then it was that void having to come back like empty-handed and i felt like they was like, you know, like,

what she did, she do something to her? I didn't know what they were gonna think. So that was the hardest part, having to come back empty handed. Like, it was like, wow. They don't forget. Like they, every night they tell, they always say their prayers and they like,

good night, Harmony. Good night, God. We love you, sister. And their prayers, and they're like, goodnight, Harmony. Goodnight, God. We love you, sister. And you go, oh, my. Every night, they always say their prayers. I tend to think of maternal and infant mortality as a problem from an entirely different era. Or I tend to think of these problems as something that afflict countries that have a lot of poverty. I don't think of this happening inside the United States in 2017, 2018.

Well, it shouldn't be happening in the United States in 2018. 2018? Well, it shouldn't be happening in the United States in 2018. Maternal mortality is a huge problem here in the United States. We are the only developed country where the rate is actually going up. And then at the same time, our infant mortality rate is high. It's 32nd out of the 35 most developed countries, wealthiest countries. So that again is odd. And both of these rates are driven by Black women, what's going on with Black women and babies. So a Black woman is two to three times more likely to die in childbirth or almost die than a white woman. And a Black baby is 2.2 times more likely to die than a white baby. And this racial disparity is actually larger than in 1850 during slavery.

It was narrower then when black women were slaves. And you're saying that the problem of infant and maternal mortality among black women is so significant that it drives the entire U.S. rate for both up. It drives the rate for both up. And why does this disparity exist? How can we account for this difference? I first heard about this in the 90s. I was the health editor of Essence magazine,

and we had been told this narrative that infant mortality is a problem of poor Black women who aren't taking care of themselves, and Black women aren't getting proper prenatal care either because they're irresponsible or because they just don't have access to it. But then studies came out that said, no, actually when prenatal care is equal, black women still have small and preterm babies. One of the statistics that really struck me was that if you're a black woman with a college education and in fact an advanced degree, you are more likely to die in childbirth or lose your baby than a white woman with an eighth grade education. Wow.

I did not believe it. I was like, no, that cannot be right. How could this be? Because the narrative was always, oh, this happens to poor women who don't take care of themselves and don't get prenatal care. But then this study in 1992 just crashed that whole thing apart. This had nothing to do with that. So then the next thing was, okay,

this has got to be genetic. So maybe there's an inherited difference that women of African descent have that is causing low birth weight. So two neonatologists in Chicago looked at Black women immigrants who had come from Africa and the Caribbean. So when the women first came, their babies weighed about the same as white babies in the United States. But then after two generations, the black babies, immigrant babies, turned out the same birth weights as African-American babies.

Which is to say low. Low, low birth weight. But you didn't see the same thing in white immigrant women. So white immigrant women came to the United States and in those two generations, their babies actually got larger. And healthier. And healthier. And so then it became, wait, this isn't about genetics. This really is about something else. Something about growing up as a Black woman in America is bad for your baby's birth weight.

You can come into this country with a healthy pregnancy, but your child and their child, if you're Black, something will happen to you. Yes. It isn't any of these other things. It isn't poverty. It isn't irresponsibility. It isn't inherited. And so now we're looking at race and racism,

the lived experience of being a Black woman in America. Essentially, being a Black woman is bad for your pregnancy. In America, something is going wrong here. We'll be right back. So I want to understand how this actually plays out in these pregnancies. Race as a force in an expectant mother's experience.

in the 90s, more recently, that talk about what happens to you when you walk into a medical facility. Black people are treated differently. There was one study that looked at medical students and they had ideas about racial differences that were not true. One that struck me was that black people have much higher pain tolerance than white people, so need less pain management, which is not true. Black people had thicker skin, again, not true. Or the idea that our blood coagulates somehow differently. These are medical professionals who have these assumptions. These are medical students who had these assumptions. And so that is frightening, because that's the next generation of doctors. And I think those two studies were very eye-opening

for me, at least. So what you're describing is a kind of unconscious, but perhaps conscious, medical racism. Yes. What's the second way that this plays out? The second way race plays out is in some ways more insidious. It's more scary, but something happens to Black women because of our lived experience of being in America. The way it's been looked at by scientists is about a kind of toxic stress. So one of the leading scientists in this area coined the term weathering. And weathering means that the body actually ages in a way that it shouldn't be aging,

according to your biological years, because of a kind of toxic stress. And she linked the toxic stress to race in America, racial discrimination. And this word weathering is very evocative because it seems to describe racism as lived day in and day out as a kind of storm that slowly ravages a body. And the body might look normal. It might seem stable and maybe even healthy, but layers of it have been stripped away. That's right. It's the idea that anytime something happens to you that makes you emotional, the systems of your body race up. It's the fight or flight syndrome. It's protective. But if it keeps happening over and over

so that your pulse races, your heart beats harder, your systems change and it's constant and it keeps happening over and over and over, it actually weathers your body. It changes your system and it makes you more vulnerable to all kinds of illness. I guess we think of racism as a societal problem. And we think of medicine as a science

that kind of hovers above all that. But maybe that separation in our minds is a false one. I think it is very false. And I think that racism and race is baked into every single thing in our society. And medicine is not immune. How have you been doing? On Monday, we talked about getting rid of the things that are stressful.

How's that been going? I really do. You've been doing the cleansing breath? Yes. And that thing is working. I have too. Yeah. I've really been doing it like and i'm like i really need to do this and it's working like i feel like it's working you know just to breathe yeah you know

i know that i'm trying like not to be anxious you know because sometimes i just get anxious it's regular like my heart feel anxious. I know that feeling. Yeah. So what happens with Simone and the second pregnancy? So with her second pregnancy, she is very committed to not letting what happened to Harmony happen again. She has a new doctor. She has a doula who is trained as a labor and delivery nurse and who is making sure that she

is going to her prenatal care appointments and she's checking in with her and making sure she's taking good care of herself. My baby, I think he get kind of scared though. He be like, mommy, like he'll talk about that. And I'm like, no, mommy, okay. Mommy not going to die because he'll tell people, you know, like think I'm sick and stuff. Yeah, because of what happened last time. So she was a little cautious. She was superstitious. She didn't want to have a baby shower. She didn't want to buy clothes for the baby

because she just wanted to make sure everything was going to be okay before she really, you know, let her heart open up to the idea that I really have this baby. So that's the way my mind thinks. Like you, you never get, even with anything, you never get too happy about like a job. Like say if they say they're going to give it to you, you don't really know if they're really going to give it to you all the time. Like you haven't thought about it like that.

They say it is, but you can't get too excited about anything. That's, that's just the way my mind be set up. Like, because there didn't have been times I didn't got excited about stuff and didn't be like, bang. You know, but I don't think like that this time. I'm trying to, like you said, just keep pushing it. We'll be okay, you know. And so what happens with this birth? So, well, the doctor said, we're afraid of you having a post-term baby because this baby wasn't, we thought the baby would be coming earlier, but he wasn't.

And so we're kind of nervous. We're thinking that by Thursday, we're going to induce him. So this was Monday. In other words, the pregnancy is running a little bit late. It was a little bit late. So we went to the doctor on Monday, and she was just getting the usual test, just seeing how the baby was. And it seemed like the baby wasn't doing so well. His little heart was going, me, me, me, me, me, me.

It didn't look normal on the screen. And so the woman who was reading the monitor said, I need to call your doctor right away. I think we're going to have to take this baby out now. She's having the baby today. So she got in her room and they started giving her the Pitocin, a medication that induces labor. And then about five hours in, the pain got pretty bad. So she needed an epidural. So Latona, the pain got pretty bad, so she needed an epidural. So Latona, the doula and I had to step out of the room. When we came back, Simone was not in a good way. She was very upset. She was clenching her fists. She was very angry. And this epidural, of course, is supposed to make things better. But they gave her an epidural that was more like if you needed a C-section, not just the regular

epidural just to alleviate the pain of labor. So it was too much? It was too much. And so Simone was really angry because she couldn't feel her legs, which is not how it's supposed to be in this kind of epidural. But also we saw her blood pressure going up and we saw the baby's heart rate kind of moving all over the place. So Latona, she said, we've got to get Simone calmed down. And so Latona was very smooth. She started massaging her hands and she started saying,

we just need to, something terrible has happened. It wasn't right. And she had the medical personnel come and explain. And actually they said, we're sorry. They had actually given her the wrong dose.

They had given her the wrong dose. She was right. So then about 1 a.m., it's time. And so a whole bunch of residents come in. And then this man who I'd never seen before, Simone had never seen before. And he said, oh, I'm Dr. So-and-so. I'm going to deliver your baby. It was like, who is this?

Who is this man? So it turns out that black women are much more likely than white women to meet the provider who's going to deliver their baby for the first time during labor and childbirth. Which is its own form of stress. Which was really stressful, but Simone was way beyond that. She was like, just get this baby out of me. And then finally, Simone was just in the zone and she was pushing and Latona was at her side saying, push, you can do this.

You've got this. And I was even doing it too. Simone pushed the baby out and the baby came out and he was very still. So they put the baby on her chest and I was holding my breath. And Simone said, is he okay? Is everything okay? And then all of a sudden, he lets out this wail and we knew he was okay. And how did Simone seem in this moment when she's

finally holding this newborn? It was everything. I've never seen somebody have so many emotions at once. She was crying. She was gasping. She was happy. She was laughing. Everything. It was all this pileup of emotions because she survived. And she has this baby, and she made it. And she named the baby Kingston, and his middle name is Blessed. It's kind of remarkable to understand, after everything that you've told us here, remarkable to understand, after everything that you've told us here, that what we're seeing here, that simply surviving pregnancy, mother and son, that that is a triumph, that that is against, in some ways, the odds. Childbirth is supposed to be this wonderful, beautiful, natural

experience. But for so many Black women and so many Black babies, it isn't. Here's what else you need to know today. On Thursday, Israeli warplanes struck dozens of suspected Iranian military targets inside of Syria as tensions between Israel and Iran reached new heights. Israel said it was responding to an unsuccessful Iranian rocket attack involving 20 missiles launched from Syria,

all of which were intercepted or fell short of their targets in Israeli-controlled territory. During a presentation on Thursday, Israel's defense minister said that the airstrikes had destroyed all of Iran's military infrastructure in Syria. If there is rain on our side, he said, there will be a flood on their side. I hope that we have finished this chapter and that everyone understands it. The Times reports that Israel and Iran have been conducting a shadow war inside of Syria, under the cover of the Syrian civil war.

But the conflict is now bursting into the open. The Daily is produced by Theo Balcom, Lindsay Garrison, Rachel Quester, Annie Brown, Andy Mills, Ike Sreeskanarajah, Claire Tennesketter, Paige Cowett, Michael Simon-Johnson, and Jessica Chung, with editing help from Larissa Anderson. executive producer. Samantha Hennig is our editorial director. Our technical manager is Brad Fisher. And our theme music is by Jim Brunberg and Ben Landsberg of Wonderly. Special thanks to Sam Dolnick, Michaela

Bouchard, David Krakals, Stella Tan, and Talia Minsberg. That's it for The Daily. I'm Michael Barbaro. A reminder that tomorrow we'll bring you the fourth chapter of our new series, Caliphate, right here on The Daily. See you Monday.