IN THE DEATH OF AN OLYMPIAN, Black moms hear echoes of their own crises
They see themselves in her story. Not necessarily the part about her being an elite athlete. But the part about being a Black woman who suffered catastrophic complications of pregnancy and childbirth, hers being fatal.
Some poured out their pain on social media, recounting the trauma they endured. Others commiserated in group chats for Black mothers or gasped in solitude, saying quiet prayers of thanks that they survived what hundreds annually do not. And many of the obstetricians, midwives, doulas and reproductive health equity researchers who said her name — Tori Bowie — with reverence also expressed exasperation that the nation’s worsening maternal health crisis claimed another victim.
“She is why we do this work,” said Joia Crear-Perry, an obstetrician-gynecologist and founder of the National Birth Equity Collaborative, a nonprofit group dedicated to eliminating racial inequities in birth outcomes. “For her to be so seen as an athlete and so unseen when it comes to being pregnant, speaks to the invisibility of Black motherhood.”
Crear-Perry was attending a federal advisory meeting on infant and maternal mortality when she checked Twitter and was stunned by the news that the 32-year-old Olympian’s death had been attributed to one of the most common causes of maternal mortality: high blood pressure.
In Bowie’s case, the medical examiner in Florida’s Orange County identified two potential contributing factors to her cause of death: eclampsia, the most severe condition on the spectrum of pregnancy-related hypertensive disorders, and respiratory distress, which can happen when blood pressure gets too high.
This tragedy “puts a name on the maternal mortality problem,” Danyelle Musselman, a former television sports anchor turned philanthropist, said in Arkansas last week after appearing at a luncheon hosted by the nonprofit Every Mother Counts during the Bentonville Film Festival. She invoked Bowie’s name before sharing her own story of a lifethreatening pregnancy complication 13 years ago.
The number of Americans dying while giving birth — or in the weeks afterward — has been increasing since 2018, from 658 that year to 1,205 in 2021, according to a March report from health officials.
Much more common but often overlooked are the near misses, the life-threatening complications experienced before, during and after childbirth. Research shows that for every maternal death, about 100 women experience severe maternal morbidity, meaning childbirth would have been nearly lethal for about 120,500 women in 2021.
HIGHER RISKS
FOR BLACK WOMEN
This life-or-death scenario is particularly true for Black women, who are twice as likely to suffer serious complications during pregnancy and three times as likely to die, regardless of income or education.
“I keep asking myself what it’s going to take for the political will and the organizational will for things to be different,” said Amanda P. Williams, an obstetrician-gynecologist from California who got a slew of messages from family and friends about Bowie’s death, which was the topic of conversation in a group chat with other Black OB/GYNs. Half of the women in that chat had suffered from preeclampsia while pregnant. “It is my passion. It is my purpose. It is my work, but sometimes you are like, ‘ . . . Another one?’”
Williams is a member of the California Pregnancy-Associated Mortality Review Committee, which found that 80% of the state’s maternal deaths are preventable, aligning with national figures showing how many pregnancy-related deaths are avoidable.
Bowie’s story felt eerily similar to Williams’s own as a top-tier track athlete in college who qualified for the 1996 Olympic trials. She was diagnosed with pree
clampsia when pregnant with her first son while chief OB/GYN resident at the University of California at San Francisco.
“Our fitness doesn’t save us. Our education doesn’t save us. Our income doesn’t save us,” Williams said.
It was a refrain repeated by Black women, clinicians and public health experts as they struggled to process a death that left them stunned but not necessarily surprised. They know the statistics. They know the stories. And still, they can’t help but wonder: “Why?”
“How loud do these bells need to ring before people start waking up?” said Regina Davis Moss, a reproductive health equity researcher and president of In Our Own Voice, which advances national and state policy priorities focused on Black women’s reproductive health, rights and justice.
SPEAKING UP
That is a question Musselman recently began asking herself, concluding that she must add her voice so the cacophony can’t be ignored.
The 46-year-old suffered a stroke when eight months pregnant with her daughter. She was living in the Bay Area while working for Fox Sports in Los Angeles. “I was on a plane every single week going back and forth, living an active life, and totally fine. No blood pressure issues.”
Then, while sitting at her computer one day, “this huge wave of a headache came on,” she recalled. “My vision went double.”
Her husband, Eric, who is the men’s basketball coach at the University of Arkansas, was home. He called her mother, a labor and delivery nurse. “Go to the hospital,” she said.
They did, only to be told by the first two doctors that she had a migraine. A third physician referred her to a neurologist who ordered a brain scan, which revealed the stroke. She was placed on a blood thinner that she had to inject into her stomach to prevent additional clots.
“There are so many times that I have thanked God over my situation,” Musselman said, noting that Arkansas has some of the nation’s worst maternal outcomes. “People think it’s the teen moms. They think it’s people on welfare. No. This happened to me, and it could happen to anyone.”
Ericka Weathers belongs to this sisterhood defined by the trauma, pain and resilience that often accompany Black women’s pregnancies.
Weathers, an assistant professor at the University of Pennsylvania Graduate School of Education, has noticed how medical professionals talk to her in a much different tone when they learn about her career and education. That wasn’t always the case. When she was a doctoral student at Stanford University and pregnant with her first child, providers dismissed her questions during prenatal visits, which felt rushed.
So when she didn’t feel her daughter move for hours, Weathers hesitated before calling the doctor, worried that doctors would think she was overreacting. She wasn’t. Her blood pressure had spiked to dangerous levels that can trigger a seizure or stroke. She had an emergency Caesarean section, hemorrhaging to the point that she required a blood transfusion.
TORI’S SITUATION
Weathers said she felt compelled to share her story because “Tori can’t.”
Frentorish — Tori for short — Bowie died at home, alone. She hadn’t been seen or heard from in several days when sheriff’s deputies conducting a wellness check discovered her body, eight months pregnant and with her daughter’s head crowning, in bed May 2, according to autopsy and police reports.
Her 5-foot-9-inch frame weighed just 96 pounds when she died, said the autopsy report, which listed bipolar disorder as part of her medical history. Mental health conditions have become one of the driving factors in the nation’s maternal health crisis, contributing to nearly one-quarter of pregnancy-related deaths between 2017 and 2019, according to a September federal report. But, maternal health advocates say, it remains one of the causes most under the radar.
Bowie’s agent, Kimberly Holland, last spoke to Bowie two weeks before her death. She was excited to hear how the woman she considered a daughter was navigating pregnancy and asked if she was going to prenatal visits. Bowie was excited about being a mom. They talked about the baby clothes she’d recently bought. Holland figured Bowie was seeking medical care given that she knew the gender of her baby: a girl.
One thing Bowie was clear on: not having her baby in a hospital. Holland did not pry into why, noting that Bowie’s decision reflects an increasingly common choice.
DISTRUST OF MEDICAL SYSTEM
Holland said she knows the harm the medical system can cause Black women. Her mother worked in health care and saw the mistreatment firsthand, so she insisted on approving which providers her children could trust. That included the physicians who helped Holland navigate her pregnancy.
Asked what she hoped would come from the conversations about Black maternal health, Holland answered: “It’s a forever conversation, and not to sound pessimistic, but it really makes you wonder, Will it ever change in this lifetime?”
The news of how the former Olympian and “Baby Bowie” died didn’t become public until last week, rippling through the United States, the worst place to give birth among high-income countries. It is the same nation that Bowie represented in the
2016 Rio de Janeiro Olympics. She won three medals, including gold in the 4x100-meter relay. Bowie ran the anchor leg.
“Three gold medalists from that 4x100 relay team in Rio set out to become mothers. All three of us – all Black women – had serious complications,” Bowie’s U.S. Track and Field teammate Allyson Felix told Time magazine.
Felix said she developed preeclampsia in 2018 while pregnant with her daughter, who was delivered early at 32 weeks during an emergency C-section. “I was unsure if I was going to make it. If I was ever going to hold my precious daughter,” she said.
The third member of the team, Tianna Madison, who went into labor at 26 weeks in 2021, wrote on Instagram, “We went to the hospital with my medical advance directive
AND my will . . . . I was NOT AT ALL confident that I’d be coming home.”
There are many unknowns about Bowie’s care. Did she trust her providers? Did her providers dismiss her concerns? Did she know what signs to look for when blood pressure gets dangerously out of whack, things like changes in vision, nausea, swelling and difficulty breathing?
“It just leaves me with a lot of unanswered questions,” said Dawnette Lewis, a maternal-fetal specialist who leads the Center for Maternal
Health at Northwell Health, New York’s largest health system.
But this, experts and advocates say, they know with certainty: Bowie’s story highlights the plight Black women face.
“I’ve been in public health for 40 years,” said Zenobia Harris, executive director of the Arkansas Birthing Project, which pairs volunteers with pregnant women to provide emotional, social and physical support through pregnancy and the first year of the baby’s life. “Infant mortality for African Americans has always been higher, and maternal mortality has always been higher but not as high as it is now. We’ve got to stop and look at the conditions that exist in our world and society that are contributing to this.”
Black women must confront racist stereotypes — lascivious, aggressive, “welfare queen” — that reduce them to caricatures, affecting not just their physical and mental wellbeing but the medical care they receive. Too often, studies and experts say, the medical establishment mistreats Black patients, dismissing requests for help, brushing off cries of pain and pressuring them into unwanted interventions such as C-sections, inductions and epidurals.
Compounding that, clinicians and public health experts say, is the unrelenting stress caused by racism that wears the body down, aging it prematurely.
“There is trauma in the system that has been normalized,” said Harris, a retired public health nurse leader. “For Black women, it’s considered a cross we have to bear.”
Black women’s experiences with medical providers have eroded trust, said Nikia Grayson, a certified nurse midwife and director of clinical services at CHOICES Memphis Center
for Reproductive Health.
“We see it every day,” said Grayson, who remembers being a novice midwife trying to compensate for the substandard care patients had received.
Grayson learned of Bowie’s death while checking headlines from back home while in Indonesia for the conference of the International Confederation of Midwives. It became a topic of conversation.
“We really wanted to see her charts. That’s the first thing,” Grayson said. “We have the same thoughts each time we hear these stories: What did we miss? What happened? What could we have done to help them? And what can we do better for the next person?”
RAISING AWARENESS
MaKayla Walker asked herself many of the same questions Tuesday night as she scrolled through her Instagram feed a world away, in Conyers, Ga.
Walker has made it her mission to raise awareness about Black women’s maternal outcomes after her own brush with death in 2020 after giving birth to her first child. So she knows the risks. Still, Walker said, it felt like the wind had been knocked out of her when she came across the post on Bowie.
“Even though I know that things can go wrong, I did not expect that,” Walker, 27, said. “No woman should lose her life while trying to bring life into this world.”
She couldn’t help but reflect on her own experiences, especially the first.
Walker, whose pregnancy was complicationfree, said her blood pressure spiked a few hours after giving birth. She spent a week in the hospital and was sent home with instructions to continue monitoring her blood pressure. Two days later, it climbed to more than twice the normal level. Unaware of the danger, she called the doctor wondering if a nap would solve the problem. It wouldn’t. The doctor urged her to get to a hospital immediately.
She did, spending seven more days in the hospital — two in intensive care — and walking away with no lasting physical damage. But the experience left psychological scars for the mother of two, who started an organization called Postpartum Warriors, which helps women understand the warning signs of serious complications.
“I try to be as real as possible without taking away the joys of being pregnant or motherhood,” Walker said. “It’s not what you see on TV.”
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FOR HER TO BE SO SEEN AS AN ATHLETE AND SO UNSEEN WHEN IT COMES TO BEING PREGNANT, SPEAKS TO THE INVISIBILITY OF BLACK MOTHERHOOD.
Joia Crear-Perry, an obstetrician-gynecologist and founder of the National Birth Equity Collaborative