Black Maternal Health of New York City

Part: 5

Embolism Stalks Black Moms With Lethal Bias

Thursday, April 28, 2011

Embolism is a major danger of pregnancy. But recent data from New York City finds black women dying from it in numbers that are startling, given the well-known interventions. A disparity in health care could be the culprit, but no one is asking.



NEW YORK (WOMENSENEWS)--When New York City issued data about maternal deaths over a five-year period, one culprit in particular leaped out at African American women: Embolism.

Of the 28 women who lost their lives to pregnancy-related embolism between 2001 and 2005, a glaring 82 percent were African American. Zero percent were white women, according to the city's health department report released in June 2010.

Hispanic and Asian pregnant women also suffered higher death rates in New York City from embolisms. Pregnant Latinas accounted for 14 percent of the embolism deaths in the study. Pregnant Asian women were 4 percent, according to the report.

An embolism, which is a blockage in a blood vessel caused by a blood clot, air bubble, fatty tissue or other substance, is always a serious matter.

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While no white women died of it in the New York study, blood normally flows more slowly during pregnancy, making venous thrombosis--the formation of clots inside the veins--a leading cause of pregnancy-related death.

Embolisms are dangerous because they may break free from the wall of the vein and travel to the pulmonary artery, which carries blood from the right side of the heart into the lungs. When blood clots get stuck in the pulmonary artery, they prevent blood from picking up oxygen. This is a medical emergency that causes symptoms similar to a heart attack.

Because the dangers are so well known, remedies are also well established.

"The most important issue in preventing embolisms after labor and delivery are early ambulation (walking) and use of medical compression stockings," said Dr. Geddis Abel-bey, an obstetrician and gynecologist at the New York Hospital in Queens, N.Y. Blood-thinning medications may also be needed.

Need for Identification

Most important, women who are at risk of embolism need to be identified so that medication can be given at the right time, Abel-bey says.

But African American women in New York--and to a lesser degree Latinas and Asians in the city--don't seem to be getting identified or treated on a par with their white counterparts.

Women's eNews asked a number of physicians and researchers in New York why not, but no one could answer that question or explain the generally higher risks of pregnancy for black women.

In New York City, African American women die eight times more often than white women due to pregnancy-related causes. Nationwide, African American women die three to four times as often as white women from pregnancy-related causes.

Dr. Jo Ivey Boufford, president of the New York Academy of Medicine, discounted obesity, poverty and pre-existing conditions as explanations for the racial differences in New York. She emphasized that while obesity and pre-existing conditions affect overall maternal health, neither one explains the dramatic gap in the pregnancy-related risks of African American and white women. Khiara M. Bridges is an associate professor of law and anthropology at Boston University and author of a recent book on maternity care and racism at Manhattan's largest and oldest public hospital. Without any biological or medical reason for such a wide disparity, Bridges, a former fellow with the New York-based Center for Reproductive Rights, suspects that simply being African American elevates the risks of having inadequate health care.

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With two articles in a few days, detailing problems for black women in receiving well researched, and adequate heath care in New York hospitals, begs several questions. In what other places are black women so at risk compared to all others? How soon are the affected hospitals going to seriously improve medical care for black women and their babies?

Women's enews events

BLACK MATERNAL HEALTH OF NEW YORK CITY SERIES

Part: 5

Embolism Stalks Black Moms With Lethal Bias

Part: 4

Study Details Causes of High Maternal Death Rates

Part: 3

Black Women's Maternal Risks Go Unquestioned

Part: 2

NYC's High Maternal Deaths Defy Usual Explanations

Part: 1

NYC's Rising Black Maternal Mortality Unexplained