The Death of Tori Bowie, Pregnancy and Social Determinants of Health

Let me put it right out there. I am the daughter of a schizophrenic, so I am well-versed in discussing mental health issues.

My beloved mother battled schizophrenia from adolescence until well into her adult life. Because of the graciousness of her sisters, who allowed me to live with them, I did not end up in the “system” (aka foster care) despite their limited resources.

Tori Bowie, like me, was not raised by her mother but by her grandmother. We do not know the circumstances, nor is it necessary. She was an Olympian in track and field, and as the mother of two cross-country state champions, I understand that journey well. The discipline. The perseverance. The pressure to be perfect in a very imperfect world.

Tori was found dead at the age of 32, pregnant and alone. It took a well-check visit by law enforcement to discover her death. How does a 32-year-old woman end up dying at home alone while giving birth?

Initially, people speculated that this tragedy resulted from a home birth gone wrong. However, the objective evidence does not support that if you dig deeper, and as a physician and MSW, I did.

The Orange County Coroner’s report states Tori weighed 96 pounds on a 5’9 frame. The calculation of her BMI (Basal Metabolic Index) results is 14.2, meaning she was significantly underweight during her pregnancy. Her weight is the type of weight you see in cancer patients.

Orange County Coroner also reported that Tori also had a medical history of Bipolar Disorder. This objective evidence is a glaring red flag that my poor sister had some deep issues. One of her friends commented that Tori’s world was becoming “more and more isolated.” “People had disappointed her.”

Her agent, Kimberly Holland, commented that Tori “did not trust hospitals.” That statement broke my heart because, as a Black woman, her reasons were valid. But back to her weight and her friend’s comments. Did the father of Tori’s baby abandon her? Was her weight loss reflective of depression? We will never know these answers. I’m not trying to pry into Tori’s personal life, but her case represents teachable lessons for the future. It demonstrates why addressing the social determinants of health of pregnant women, especially women of color, is so important.

Tori Bowie’s case highlights the importance of checking in on friends and family even when they don’t want us to. Even if it means getting on a plane, especially if they’re pregnant, it may mean you get your feelings hurt, and I have borne witness to that regarding a personal family issue that I will not discuss.

Yes, Tori died from complications of pregnancy that included eclampsia and respiratory failure, but I suspect my sister also died of a broken heart.

 

Tina Turner’s Death Puts Hypertension in the Spotlight

On May 24, 2023, Tina Turner’s death was announced at the age of 83. The iconic singer’s death has spotlighted hypertension and kidney disease. Hypertension (also known as high blood pressure) is a condition that affects millions of people worldwide. In most cases, it is treatable with lifestyle changes and medications. Tina Turner’s words about high blood pressure (hypertension) haunted me. The picture of her on dialysis haunted me. Essentially, she said, if she knew better, she would have done better.

Many pregnant women who have preeclampsia or hypertensive disorders of pregnancy continue to have blood pressure problems after having a baby.

According to the Centers for Disease Control and Prevention (CDC), one out of every three deaths in America is caused by heart disease or stroke—two conditions that are often associated with high blood pressure. It is especially dangerous for African Americans. We can never receive enough information about combatting this deadly disease.

 

HGTV Celebrity Couple Lost Cousin in Childbirth

Every time I write one of these posts, it breaks my heart, but these women’s deaths would go unnoticed without raising public awareness.

If you are interested in receiving information about the Black Ob-Gyn Directory that will drop in February 2023, please contact me at DoctorLindaOnline@gmail.com or https://www.thesmartmothersguide.com/contact/

 

Happy Father’s Day: 10 Important Things an Expectant Dad Can Do to Help Have a Healthy Baby

This blog was originally written in 2011 but it still holds true today.

Some of the most endearing moments I have witnessed as an obstetrician involved observing men in the labor room. There was the Jewish dad from Brooklyn who brought his Anita Baker tape and played it while his wife was in labor. Because she was one of my favorite artists, I was constantly in their room under the guise of watching the fetal monitor, just so that I could listen to the music. Another memorable moment was the dad who cried tears of joy when his wife was returned back to her room after having a c. section. The love and admiration that beamed in his eyes almost tempted me to ask him if he had a friend (this was of course when I was single). The point is, that expectant dads can play a significant role in helping their wives or girlfriends have a healthy babies. Here’s how:

  1. Remind the baby’s mother to make certain she feels the baby move at least 4 or more times in one hour.
  2. Make sure she knows what her blood pressure is at each prenatal visit
  3. Make sure she keeps all of her prenatal appointments
  4. Make certain her hospital bag is packed and she has all her important papers in one specific location
  5. Ask permission to be in the labor room with her so that you can witness the birth of your child. It is a scene you will never forget and will bring you closer together as a couple.
  6. Please don’t cheat on her while she’s pregnant. You could give her an unwanted sexually transmitted infection
  7. Encourage her to push when it’s time
  8. Rub her back in between contractions
  9. Take notes when she’s in labor. If there’s a change of shift, make sure that the new shift knows what went on during the previous shift; particularly if she’s having complications such as high blood pressure or fetal distress on the monitor. One of the greatest risks of OB medical malpractice is miscommunication or a lack of communication during shift changes. The proverbial left-hand doesn’t always know what the right hand is doing.
  10. If the nurses become concerned about the baby’s fetal tracing, ask that the doctor or midwife come to the hospital immediately.

The active participation of an expectant father is priceless. In the words of an old R&B classic by the Winstons, “. . . color him father; color him love.” Happy Father’s Day.

Soulmates Left Behind on Mothers’ Day

Charles Spurgeon Johnson, Anthony Wallace, Juwan Lopez, and Bruce McIntyre III.

On this Mother’s Day, I honor the soulmates of mothers who left before their time on earth based on clinical incompetence, arrogance, and, yes, that dreaded word no one wants to discuss but is ever apparent racism.

Here are some examples of why Sha-Asia Washington, Amber Rose Isaac, Kira Johnson, and Dr. Chaniece Wallace are no longer with us:

Dr. Dmitry A. Shelchkov, a foreign medical school graduate, failed to provide adequate oxygen or monitor three previous patients before finally killing Sha-Asia Washington. He did not give her oxygen when she became short of breath and placed her epidural catheter incorrectly. His mistakes had been known for years, but it took the death of a 26-year-old first-time mother before the New York Medical Board suspended his medical license.

The obstetrician who performed a 17-minute elective C-Section led to a postpartum hemorrhage and the preventable death probably of Kira Johnson. Unfortunately, he probably still has privileges at the infamous Cedar Sinai Hospital.

The ob-gyn residents and their attending physicians at Montefiore Hospital who missed Amber Rose Isaac’s dropping platelets are probably still practicing without any accountability except providing a pathetic apology that will not bring her back to life.

And then there’s the case that keeps me up at night involving my fellow physician colleague and sorority sister, Dr. Chaniece Wallace. The horrific two-hour delay of starting an intravenous line in the setting of her hypertensive crisis is chilling. Yet, St. Vincent’s Hospital in Indiana purports to have given her the best care.

Yet, amid this madness, four remarkable men have turned their pain into action on behalf of their departed soulmates. Their comments and posts on social media platforms demonstrate a palpable love. They speak about their beloved in the present tense. They not only continue to love these women but remain IN love with them despite their physical absence of 6 years for Charles Spurgeon Johnson IV and two years for Anthony Wallace, Juwan Lopez, and Bruce McIntyre III.

These brothers teach us that love continues to win, even in death, and has created beautiful children that represent their legacy.

Today, I salute the soulmates of Kira, Sha-Asia, Amber, and Chaniece, who continue to teach all of us that death has no real power over love, just as it had no power over Jesus, the Christ.

May my sisters continue to rest in Power, and may their memory continue to be a blessing.

 

My Mother Would Die if She Gave Birth to Me Today

Used with permission of E Bere Illustrate

If my mother gave birth to me today instead of over 60 years ago, she would probably be dead based on her risk factors. She was Black, had gestational diabetes, and gave birth to a 9-pound 4-ounce baby girl via C-section. She would have been discharged from the hospital on post-op day four rather than post-op day seven. But, thank God, my mother, unlike her mother, lived. I never knew my grandmother because she died from postpartum cardiomyopathy at age 39, a few months after delivering my youngest aunt in 1939.

When my mother had me, there were no managed care organizations that booted women out of the hospital 48 hours after birth or 96 hours after having a C-section. Had the federal government not stepped in with the Newborn and Mother’s Health Protection Act of 1996, mothers and babies would have been sent home after 24 hours, a phenomenon sarcastically referred to as “drive-through deliveries.”

In the discussion of reasons for the ignominious U.S. maternal mortality rates, the topic of managed care organizations and private equity investors is never discussed but should be.

According to Medical Economics, the Medical Management Group Association (MMGA) reported $60 billion in “deals” involving medical practices in 2019 by private equity firms. They are one of the reasons why nurses are leaving hospitals, physicians are jumping off hospital roofs, and yes, women are dying within a week of having a baby, and the stillbirth rate has increased.

The business model is not taught in nursing, midwifery, or medical schools. As a result, we do not know how to compromise quality care and satisfy your shareholders simultaneously. Perhaps if hospital CEOs and private equity shareholders are named co-defendants in future medical malpractice cases, the maternal mortality rate will move in the opposite direction.

You profess not to know why more pregnant women are dying? Try taking a closer look at your priorities and business practices. As long as profit and revenue take precedence over human life, there is little hope for change.

The U.K. Approves an Early Preeclampsia Diagnostic Test. Will the U.S. Follow?

A decision made by the British version of our NIH, the National Institute of Care and Excellence (NICE), sheds a flicker of light onto a very dark landscape regarding maternal mortality. They are authorizing the use of a blood test that will diagnose preeclampsia as early as 20 weeks. This decision is groundbreaking news and will change the landscape of how preeclampsia is currently diagnosed, treated, and hopefully save lives.

NICE is developing a draft of clinical guidelines and believes that African, Caribbean, and Asian women will benefit the most based on their history of adverse birth outcomes.

Here’s what you need to know in plain English about the test:

  • It measures Placenta Growth Factor (PIGF), which is a protein that plays a role in the development of blood vessels in the placenta
  • Women who have preeclampsia have low levels of PIGF. Low levels of PIGF means that the placenta blood vessels do not grow well

Can these tests diagnose as well as exclude preeclampsia?

Yes, according to published literature cited in the article.

Who makes these tests?

Four independent labs: one in San Diego, two in Germany, and a lab in Finland

What are the benefits of using this test for pregnant women?

The tests will make it easier for healthcare providers to diagnose preeclampsia and make fewer mistakes regarding clinical management.

Are there any economic benefits of using this test?

According to NICE literature, the saving was between 26 pounds ($34.06) to 2,896 pounds ($3,793.76) per patient.

Are there any other early diagnostic tests for preeclampsia?

Yes, there is a test using different technology that measures cell-free RNA as a means of early preeclampsia detection, according to an article published by Nature.com. However, healthcare providers do not currently use this test because it has not been approved as part of clinical guidelines.

I anxiously await the use of PIGF in mainstream obstetrics. We once thought that the adverse effects of preeclampsia stopped when the baby and placenta were delivered. However, we now know that reasoning was wrong based on the number of women who died during the postpartum period. Hopefully, with the future use of this test, women will no longer be discharged from hospitals or emergency departments prematurely. Anything that decreases maternal mortality gives me a glimmer of hope.

 

Four Infants Hospitalized and One Death Force FDA Recall of Infant Powered Formulas

 

On February 25, 2022, the FDA issued a recall regarding three powdered infant formula brands made by Abbott Nutrition associated with bacterial infections, Salmonella and Cronobacter, which have produced at least one infant death and caused severe illnesses in three.

The contaminated powdered formula was manufactured in Sturgis, Michigan, and cases were reported in Minnesota, Ohio, and Texas between September 20, 2021, and January 11, 2022, involving Similac, Alimentum, and EleCare. The FDA recommends consumers look at the lot code, a multidigit number on the bottom of a container of powdered infant formula. The involved lot numbers are:

  • the first two digits of the code are 22 through 37; and
  • the code on the container contains K8, SH, or Z2; and
  • the expiration date is 4-1-2022 (APR 2022) or later.

Need more information? Please visit Abbott’s website to check lot numbers if you have purchased any of the brands mentioned earlier. Abbott has also provided a phone number, 1-800-986-8540. In addition, information regarding symptoms of bacterial infections is located on the FDA’s website.

Aside from breast milk, infant formulas are the only source of nutrition for babies and newborns; therefore, this recall is a serious issue. In the interest of public safety, please share this information with all new moms and families.

Asl always, remember knowledge is power. Share and empower.