The tragic Jan. 2 death of Janell Green Smith, a South Carolina certified nurse-midwife and Doctor of Nursing Practice, who died after delivering her first child due to complications related to preeclampsia, has reignited the conversation about Black maternal health and the racial disparities that exist in the United States.
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Although her due date was Feb. 25, Smith was admitted to the hospital on Dec. 31 after developing a severe case of preeclampsia. Her baby was delivered safely on Jan. 2, but sadly, Smith, who devoted her life to supporting expectant mothers, did not survive.
Preeclampsia is a complex cardiovascular condition that occurs during pregnancy, which, if left untreated, can be fatal to mother and baby. Although the CDC reports that the condition occurs in 5 to 7 percent of all pregnancies, a closer look at the numbers shows that cases are disturbingly disproportionate in the Black community, with a preeclampsia rate that is 60 percent higher than that of white women.
The Root spoke exclusively with Dr. Kaytura Felix, a nationally respected health justice scholar and distinguished scholar at the Johns Hopkins Bloomberg School of Public Health, about the risk factors related to preeclampsia and what can be done to support positive maternal health outcomes for Black women.
Understanding the Under-Recognized Risk Factors
According to Dr. Felix, preeclampsia is more likely to occur during the first pregnancy with pre-existing conditions, such as hypertension, high blood pressure, and a prior history of the condition, increasing the risk in expectant mothers. However, she adds that things like racism and chronic toxic stress are also under-recognized risk factors that Black women should be aware of.
“Chronic stress changes the body’s chemistry by overloading the hormonal and immune systems. And when the body has to endure high levels of stress, systems fail, and disorders like preeclampsia can develop,” she said.
Reducing Risk
Although there are no CDC-recommended tests that can predict preeclampsia in pregnancy, Dr. Felix says there are things Black women can do before they get pregnant to help reduce their risk, including taking an honest assessment of their stress level.
“Do a stress inventory. Ask yourself, ‘Is my stress chronic?’ ‘Is it increasing?’ ‘Is my stress undermining my health and well-being?’” she said.
And while there is no way to completely eliminate stress, Dr. Felix says Black women should arm themselves with the tools they need to manage it, including surrounding themselves with supportive family members and friends, prioritizing sleep, nutrition, daily movement, and spirituality, and finding healthcare providers – including midwives and doulas – who are both caring and competent.
“I tell Black women to find their posse. These are the people who have your back and will support you during your pregnancy journey,” she said.
“Midwives tune into their clients, understanding their needs and those of their families. They can provide a calming and nurturing presence for expectant mothers that allows them to enjoy their pregnancy, knowing that someone else has their back,” she said.
How the Government Can Help
Dr. Felix says the government can help increase positive health outcomes for Black mothers by investing in services and support including, doulas who can advocate for Black mothers (especially for those delivering in hospitals), as well as more community birth centers in Black, rural and low-income communities. She says they can also help reduce new moms’ stress by providing at least six weeks of paid family leave for the birthing person and their partner.
“Today, more than half of Black women on maternity leave do so without pay. That also means that they are more likely to work up to the day before or on the day of delivery. Stress not only taxes the pregnancy but also the process of childbirth,” she said.
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