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Taking a closer look at Black maternal health in Arkansas

The birth of your child is a joyous time for families, but for Black women that joy can be overshadowed by the fear of health complications along the way.

LITTLE ROCK, Ark. — Having a baby is usually a happy time for families,  a time of incomparable excitement.

For Black women, that joy can be overshadowed by the fear of the health complications that they could face, as studies show they often face a higher risk of dying during labor or delivery.

That's a fear that almost became a reality for Shanea Nelson, a mother who almost lost her life during childbirth.

Nelson is very healthy today, but rewind the clock back to 2014 when she 32 weeks pregnant, and it's a different story. 

She was headed in for what she thought was a routine appointment, but after a quick check of her blood pressure, nurses put her on her side and found that she was suffering from severe-eclampsia.

By the time doctors found the complication, the condition had reached stroke level. 

The only cure? Delivering Nelson's baby, which came out weighing 3-lbs and spent one month in the NICU.

It was an extremely, and understandably scary time for Nelson-- it's also one that would repeat itself 4 years later.

Unfortunately, this time the health scare was far worse this go around, with Nelson developing severe pre-eclampsia 6 weeks earlier than her previous pregnancy. 

"When Emory [Nelson's child] was delivered by emergency c-section, it was a very traumatic experience in the way that she was delivered," she said.

The baby's heart rate plummeted and she was in severe danger at that time.

Not only was the health of the child in jeopardy, so was Nelson's. It was a scary reality with her new doctor telling her bluntly that there was a chance she could die.

"That's exactly how he said it, just no compassion at all," Nelson said.

In a turn of events-- Nelson's OBGYN arrived and stopped the emergency c-section, opting to wait until it was safer to perform the surgery.

"I'm convinced that had things gone in the way that they had initially planned, I don't think I would have woken up from the anesthesia," Nelson said.

Nelson's experience is all too similar to other black women, not only in Arkansas, but throughout the world. 

These moms don't always have the same outcome and many don't have the chance to share their stories.

According to the CDC, in 2020 the maternal mortality rate for white women was 19.1 per 100,000. You compare that to Black women where the rate sits at 55.3 per 100,000. But why is it higher for black women?

"Pregnancy associated versus pregnancy related," said Dr. Glorida Richard Davis, executive director of Equity and Inclusion.

Dr. Richard Davis said that institutionalized racism is the foundation of the issue and that it creates more problems.

"Oftentimes women try and communicate to their providers that something's not quite right. They may not know exactly how to convey that, but they know something's not right and oftentimes, they're brushed off," Dr. Richard Davis said.

That dismissal was something that impacted Nelson.

"I shared with my doctor that I wasn't feeling well and it was sort of dismissed as 'Oh well, you're pregnant,"' Nelson said.

There are other factors that have a hand in why Black women, specifically in Arkansas, have higher rates of maternal mortality such as:

  • Where in the state do they live?
  • Do they have underlying health issues?

Dr. Creshelle Nash with arkansas Blue Cross Blue Shield said that Arkansas is severely under-served medically.

"If something happens acutely and you need to get care, you're trying to get to an urban center, to a UAMS or other institutions, that can have an impact on your health outcomes," Nash said.

Studies show that of the Black maternal deaths in 2020-- 92% of them were preventable, which begs the question-- what's it going to take?

It's something that Dr. Clare Brown has been thinking about. She breaks it down as a tier approach:

  • The policy tier
  • The individual tier
  • The healthcare provider level

The individual tier is all about women and their support system, making sure that they know the symptoms that could lead to a severe maternal event.

Next, we have the health policy. By having Medicaid expansion there, women who are low income are able to have insurance prior to their pregnancy or in between pregnancies. This ensures that they're able to get those conditions under control and allows them to develop a relationship with a provider.

Lastly, we have the health provider level, which requires hospitals and doctors alike to do the work to create culturally aware spaces.

Having that awareness can ultimately allow for a provider to help treat their patients better.

Those are three important points that doctors said will help protect expecting mothers, especially ones at a higher risk.

It's a risk that Nelson knows all too well, which is why she urges Black mothers to ask questions and don't be afraid to get a second opinion.

"We focus so much about the joy of bringing life into the world, but we don't talk about some of the dark sides associated with pregnancy," Nelson said.

Common pregnancy symptoms can actually be warnings of something way worse.

If you'd like to learn more about those symptoms, the Arkansas Department of Health and the CDC have resources for Black women who are pregnant.


       

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