At the start of 2019, Bill and Melinda Gates released a list of facts that had surprised them the previous year. Number four on their list: “Data can be sexist.”
“There are huge gaps in the global data about women and girls,” they explained.
My interest was piqued – not only as a demographer, but as a woman and mother of girls.
I research women in global Christianity and am frequently asked what percentage of the religion is female. The short answer is 52%. But the long answer is more complicated – women make up a much more substantial part of Christianity than that number makes it seem.
The goal of my research is to put the spotlight on Christian women’s contributions to church and society and fill in gaps in our data. Headlines about religion may be focused on the words and actions of Western male leaders, but the reality of the worldwide church is quite different. More and more Christians live outside Europe and North America, especially in Africa – and women are central to that story.
What researchers don’t have is comprehensive data on women’s activities in churches, their influence, their leadership or their service. Nor are there comprehensive analyses of Christians’ attitudes around the world about women’s and men’s roles in churches.
“Women, according to an old saying in the Black church, are the backbone of the church,” notes religion and gender scholar Ann Braude. “The double meaning of this saying is that while the churches would collapse without women, their place is in the background,” behind male leaders.
But there’s not much actual data, and without good data, it’s harder to make good decisions.
Christianity continues its demographic shift to the global south. In 1900, 18% of the world’s Christians lived in Asia, Africa, Latin America and Oceania, according to my research. Today that figure is 67%, and by 2050, it is projected to be 77%. Africa is home to 27% of the world’s Christians, the largest share in the world, and by 2050, that figure will likely be 39%. For comparison, the United States and Canada were home to just 11% of all Christians in the world in 2020 and will likely drop to 8% by 2050. Furthermore, the median age of Christians in sub-Saharan Africa is just 19.
One of the most common refrains about the church in Africa is that it is majority female. “The church in Africa has a feminine face and owes much of its tremendous growth to the agency of women,” writes Kenyan theologian Philomena Mwaura.
Or as a Nigerian Anglican bishop recently told me, “If anyone tells you a church in Nigeria is majority male, he’s lying.”
It’s clear that women have been a crucial part of Christianity’s seismic shift south. For example, consider Catholic sisters, who outnumber priests and religious brothers in Africa – and on every continent, in fact. Mothers’ Union, an Anglican nonprofit that aims to support marriages and families, has 30 branches in Africa, including at least 60,000 members in Nigeria alone. In Congo, women have advocated for peacebuilding, including through groups like the National Federation of Protestant Women. Next door, in the Republic of the Congo, Catholic sisters were at the forefront of providing shelter, education and aid in postwar recovery efforts.
Yet here, too, more precise data about African women’s contributions and religious identities is lacking. And beyond quantitative data, African women’s narratives have often been ignored, to the detriment of public understanding. As African theologians Mercy Amba Oduyoye and Rachel Angogo Kanyoro have stated, “African women theologians have come to realize that as long as men and foreign researchers remain the authorities on culture, rituals, and religion, African women will continue to be spoken of as if they were dead.”
Far from dead, African women live at the center of the story – and will continue to do so as healers, evangelists, mothers and the heartbeat of their churches.
As more women than ever continue to move into positions of leadership and all women seek their purposes it is important to have role models from Scripture to help inspire and encourage us. Michelle McClain Walters has identified not only role models, but Biblical principles that can be learned from their stories to help women and men discover and walk in God’s calling for their lives. UrbanFaith sat down with Michelle to talk about her new book Legendary Woman: Partnering with God to Become the Heroine of Your Own Story, which captures the wisdom and encouragement we need for this moment. The full interview is linked above and more about the book is below.
In today’s times of women go-getters, entrepreneurs and bosses, Michelle McClain Walters uses her faith and God’s promises to motivate women to their calling! The book highlights the legendarywomen who aren’t just those in traditional powerhouse positions in business, finance or politics, but also the everyday women — the single mom, the prayer leader, the stay-at-home wife— who choose to say yes to God, are also indeed, legendary. She also shares the twelve characteristics of a legendarywoman,and challenges women to identify their defining moments—those moments when your destiny intersects with an epic need within your family, community, nation, or your world—and be willing to say yes to the legendary role God has uniquely fashioned for them.
Shamony Makeba Gibson was in her hospital room, recovering after giving birth, when she said something that worried her mother.
Gibson had just delivered her second child, Khari, a healthy baby boy, via C-section at Brooklyn’s Woodhull Hospital on Sept. 23, 2019.
But in the delivery room while prepping for her surgery, Gibson told her mother, doctors had briefly struggled to insert an IV in her hand — likely because of a blood clot, she said they informed her.
Shawnee Benton-Gibson’s concern for her daughter was based on her years of reproductive justice activism in New York City, working with mothers and families dealing with issues like postpartum depression and stillbirths.
Back at home after leaving the hospital, Gibson felt fatigued and short of breath, her mother recalled in a phone interview with THE CITY.
“I talked to her about pulmonary embolisms, but she said they checked her in the hospital for it,” Benton-Gibson said.
Besides, her daughter argued, she was taking anticoagulants — commonly prescribed after surgeries, including C-sections — and was wearing compression undergarments the hospital gave her to improve circulation. But her fatigue and shortness of breath persisted.
‘My Best Friend’
One evening in early October, watching TV in the Bedford-Stuyvesant apartment she shared with her partner and their children, Gibson collapsed. EMS workers resuscitated her and rushed her to Interfaith Medical Center, the nearest hospital.
There, doctors found blood clots had spread to her lungs and legs.
Gibson — an artist who was “very funny” and “loved to sing,” according to her mother — died 14 hours later on Oct. 6, two weeks after her son was born.
The cause of death was the condition her mother had suspected: a pulmonary embolism. She was 30 years old.
Her children live with Omari Maynard, their father and Gibson’s partner of seven years.
“She was very fiery like me,” said Benton-Gibson, 51. “She was my best friend.”
Stark Disparities Persist
On Thursday, Benton-Gibson joined other women like her — grandmothers left to help raise their grandchildren after the sudden deaths of their own daughters — for #HearUs, a virtual pre-Grandparents Day event to raise awareness about Black maternal mortality.
According to the U.S. Centers for Disease Control and Prevention, 700 women die in the United States each year from pregnancy-related complications. By the CDC’s estimates, two-thirds of those deaths occur in the days and weeks postpartum — and about two-thirds of deaths overall were determined to be preventable.
A 2017 study by the medical journal The Lancet found that the United States has the highest rate of maternal deaths in the developed world — a trend that’s steadily increased over the last two decades.
Brooklyn, where Gibson lived, is home to three neighborhoods that rank highest in the city for non-fatal but serious pregnancy-related illness, or severe maternal morbidity, according to a 2016 study by the city Department of Health and Mental Hygiene.
In Brownsville, which has the city’s highest rate of such incidents at 497.4 per 10,000 deliveries, 79% of all deliveries were to Black non-Latina women.
The borough is also home to the neighborhood with the city’s lowest rate of severe maternal morbidity — largely white Borough Park, with a rate of 113.3 per 10,000 deliveries, according to that same DOHMH study.
Gibson’s death was particularly wrenching for Davis, who worked at the city’s health department for more than a decade.
She knew Gibson and her mother well from their reproductive justice work in Brooklyn. Benton-Gibson was the first person to offer Davis a public speaking opportunity on maternal well-being, she noted.
“I can tell you that she has saved lives,” Davis said of Benton-Gibson’s activism. “I can tell you that Shamony [also] has saved lives. And all that knowledge was not enough to save her own life.”
The Thursday evening event — equal parts memorial, group therapy session and rally — brought together women from New York, California, Alabama and Georgia who’d lost their daughters, and in one case, a grandchild as well, to complications stemming from childbirth.
‘All that knowledge was not enough to save her own life.’
Most of those women have embraced a life of activism after the sudden loss of their loved ones.
Among them were Maddy Oden, of Oakland, Calif., who became a doula after the 2001 deaths of her daughter, Tatia Oden French, and her grandchild Zorah, during delivery.
Also attending was Wanda Irving, mother of Shalon Irving, a 36-year-old CDC epidemiologist in Atlanta who died in 2017 from complications of high blood pressure weeks after delivering her daughter.
“Women know their bodies best and know when something doesn’t feel right,” Shanna Cox, associate director for science for CDC’s Division of Reproductive Health, told THE CITY. “The campaign is encouraging women to speak up — during and after pregnancy — if they have health concerns.”
Calls for Justice
Benton-Gibson, a longtime community organizer and licensed social worker, founded The A.R.I.A.H. — Association for Reproductive Innovation through Artistry & Healing — Foundation, which “works to stop the devastation of Black maternal mortality,” in the aftermath of her daughter’s death.
“I’m conflicted: Do I cry? Yes. Am I upset about this? Yes. Do I sometimes wake up and feel like ‘What the…?’” Benton-Gibson said at the event.
“But my bigger stand is that that girl lived all the days that she lived, and I don’t want those days that she lived to be in vain so that the day she passed took over,” she added. “But how she passed — that’s what every breath in my body will be about, because I’m making sure that this never happens again.”
It’s a similar position to the one Bruce McIntyre found himself in nearly six months ago when his partner, Amber Rose Isaac, died during delivery at Montefiore Medical Center in The Bronx in April during the coronavirus crisis.
On Aug. 1, McIntyre hosted a “Mothers March,” a rally for Isaac and others who died from pregnancy-related causes. Dozens, including Benton-Gibson, attended the event and donned purple in Isaac’s memory.
Also at the march was the family of Sha-asia Washington, who died during delivery on July 3 at Woodhull Hospital, where Gibson gave birth last year.
“I’m staying up all night holding the baby that she should be here holding,” Desiree Williams, Washington’s mother-in-law, said at a separate rally in July in front of that hospital. “It’s not fair, it’s not right. My son is broken down, it’s not right.”
‘She Was Really Happy’
Gibson, an artist who specialized in dance, was “very savvy in graphic design,” and “loved to travel,” her mother said. The Medgar Evers College graduate had visited 10 countries.
She wanted a big family, Benton-Gibson said: five children, which she tried talking her out of, without much success.
“She loved the idea of having children,” she said.
Courtesy of Shawnee Benton-Gibson Shamony Makeba Gibson and her partner, Omari Maynard
When Benton-Gibson became pregnant for the second time in 2019, she knew exactly the kind of birth she wanted.
She had delivered her first child two years prior, a baby girl named Anari, via C-section. When she found out she was expecting Khari, she pored over information about natural births, and at one point even considered a home birth.
She researched doulas and midwives in her area and eventually hired one of each, including a Black doula who lived a short walk from her Bedford-Stuyvesant apartment.
“She was really happy, had a baby shower and everything,” Benton-Gibson said.
But after she checked into the hospital, doctors told her she needed another C-section.
Before that news, she had told her mother, “This birthing experience is going to be different.”
THE CITY is an independent, nonprofit news outlet dedicated to hard-hitting reporting that serves the people of New York.
In April, a 25-year-old black woman named Chikesia Clemons was violently arrested by police at a Waffle House restaurant in Alabama.
A video of the arrest that went viral shows police pulling Clemons from her chair and throwing her to the floor. In the process, her breasts are exposed and her dress rides up in the back. When she attempts to cover her breasts, the two officers on top of her threaten to break her arm for “resisting.”
Clemons’ experience is not uncommon. In the U.S., black women are not afforded the same regard for bodily privacy as white women.
Another example: In an investigation of the Baltimore City Police Department, the Department of Justice found that the Baltimore Police Department frequently engaged in unjustified strip searches of African-Americans. In one instance, Baltimore police conducted a strip search of a black woman, including an anal cavity search, on a sidewalk in broad daylight and in full public view. The woman’s pleas to not be forced to disrobe in public were ignored. Her offense? A broken headlight.
While the #MeToo movement has been successful in bringing down several high-profile assailants, critics continue to argue that it has been monopolized by middle- and upper-class white women, particularly white Hollywood actresses. This, despite the fact that a black woman, Tarana Burke, created the Me Too campaign more than a decade ago. These criticisms reflect the fact that black women have experienced sexual violence differently than white women.
As a philosopher of race and gender who has written about sexual harassment, I offer historical context on the ways that black women experience sexual abuse, often by the authority of the state, as a way to think about black women’s contemporary experiences as the kinds of experiences that #MeToo should address.
In this Dec. 8, 2017, file photo, Anita Hill and Fatima Goss Graves join a discussion about sexual harassment in Beverly Hills, Calif. The sexual assault allegations against Supreme Court nominee Brett Kavanaugh recall Hill’s accusations against Clarence Thomas in 1991, but there are important differences as well as cautions for senators considering how to deal with the allegations. (Photo by Willy Sanjuan/Invision/AP, File)
History of black women’s bodies on display
As early as the 17th century, European men wrote travel narratives about their trips to West Africa to capture, enslave and trade African people. Their writings offer a window into how they perceived African women and what they thought primarily European male readers would find titillating.
In particular, their descriptions of West African women’s style of dance played a role in shaping European perceptions of black women’s sexual immorality and availability.
These travel accounts were the popular media of their day and offered some of the first reports of continental Africa to average Europeans. For example, Frenchman Jean Barbot wrote of African men and women “knocking bellies together very indecently” while “uttering some dirty mysterious words.” Meanwhile, naval officer Abraham Duqesne characterized African women as desiring the “caresses of white men.”
Because African women differed from European women both in attire and bodily movement, European travel writers regarded African women as sexually available and immoral. European settlers carried these attitudes to the United States where enslaved black women were subjected to violent sexual abuse and forced nudity as routine social practice, in ways that would have been unthinkable toward white women.
Sexual violence and the father of gynecology
By the 19th century, treating black and white women differently was firmly entrenched in society. Nowhere was this more evident than in the practice of J. Marion Sims, the physician widely regarded by gynecologists as the “father of modern gynecology.” The convention of the period was for physicians to conduct gynecological examinations of white women with averted gazes while the patients remained as clothed as possible.
However, Sims also conducted medical experiments on enslaved black women that ultimately resulted in a technique to repair vesicovaginal fistula, an opening that can develop between the vaginal wall and the bladder or large intestine, sometimes as a result of childbirth. The enslaved black women were stripped completely naked and examined on all fours, as Sims and other physicians took turns using a specially created speculum that enabled full viewing of the vagina. Private citizens were also allowed to watch these experiments and they, too, were invited to witness the full exposure of enslaved women’s vaginas.
Sims conducted his experiments without anesthesia, despite the fact that ether was known and in use by the time he performed later surgeries. Black women were denied anesthesia on the grounds that black people did not feel pain in the same ways that white people felt pain, a perception that still exists today. For example, one study found that when people viewed images of blacks receiving painful stimuli, like needle pricks, they responded with less empathy than when they viewed similar images of white people in pain.
Sexual violence in a court of law
In New York in 1925, another historical example shows how black women’s exposed bodies have been treated with indifference. Kip Rhinelander, a member of New York’s high society, was set to wed Alice Beatrice Jones, a working-class biracial woman. Their union drew national attention.
Although New York did not legally prohibit interracial marriage as other states did at that time, society strongly disapproved of interracial marriage.
Once their marriage was made public, Kip filed for divorce on the grounds of fraud. The salient question in the divorce hearing was whether Kip knew that Alice was black at the time of their marriage.
In order to answer that question, Alice’s attorney suggested that Alice bare her breasts in front of the all-white male jury, judge and attorneys in order to prove her racial identity. By viewing the shading of her areolas and legs, he said, the jurors could assess whether Kip – who had admitted to premarital sex with her – should have known her racial identity.
The judge directed Alice to follow through. Neither Alice Rhinelander’s tears nor her connection to a prominent white family could save her from the indignity of forced nudity in front of strangers. Ultimately, the jury decided that Alice was, in fact, “of colored blood” and that she did not conceal or misrepresent her racial identity.
The past is present
The hostility to black women’s bodily privacy and dignity in these examples isn’t accidental. Rather, it is part of the history of how black women have been cast in U.S. society.
In the Sims and Rhinelander examples, the legal status of enslavement and weight of the court validated the coercive display of black women’s bodies. The Department of Justice found that the Baltimore police used the weight of their badges to force compliance with public strip searches. Likewise, in the Waffle House example, although Clemons’ initial exposure may not have been intentional, the police responded to her cries and her attempts to cover herself by using their authority to threaten her with further harm.
This is a unique form of sexual violence experienced by black women. The convergence of race and gender in black women’s lives has created the social conditions in which black women are coerced and often expected, under threat of punishment by the government, to suffer the exposure of intimate body parts.
Race and gender converge in black women’s lives and have created the social conditions under which black women are coerced and expected to suffer the exposure of intimate body parts, or else face punishment. If movements like #MeToo are serious about combating sexual violence, then they have to also understand these practices as sexual violence.
About 700 to 900 women die each year from causes related to pregnancy and childbirth. And for every death, dozens of women suffer life-threatening complications. But there is a stark racial disparity in these numbers. Black mothers are three to four times more likely to die than white mothers. Nevertheless, black women’s voices are often missing from public discussions about what’s behind the maternal health crisis and how to address the problems.
It is estimated that up to 60 percent of maternal complications are preventable. One way to prevent them is to talk to and learn from women who have nearly died from these complications. So, we reached out to nearly 200 black mothers or families that shared stories of severe complications as part of our maternal health investigation Lost Mothers.
Since this disparity has existed for decades, we were interested in learning how it might have affected generations of black women — and maybe even women in the same families.
We also know difficult conversations can sometimes be easier with a loved one. We asked women if they would be willing to discuss their near miss with their mother or daughter.
To help navigate these tough conversations, we gave each pair of women a tailored set of questions and got out of the way (you can download a copy of the questions here). We spent an hour recording them, some in their living rooms and others over the phone. We’ve organized these conversations by the complications each woman faced. We included several generations of women from 6 to 64 years old.
A postpartum hemorrhage (PPH) occurs when a woman experiences heavy blood loss after giving birth. In developed countries, pregnant women nearly die from this complication more than any other. The most common cause of PPH is uterine atony, which means the uterus isn’t contracting effectively after delivery. However, having fibroids (benign tumors in the uterus), any kind of infection or a systemic blood clotting disorder can also cause PPH.
Heather Dobbs was 41 weeks pregnant when she went into a prolonged labor. Eventually she was induced and had an emergency cesarean section at a hospital near her home at the time in rural Texas. Dobbs, 37, an educator and editor now living in Covington, Georgia, says there were no further complications. After the C-section, both Dobbs and her new son Cameron were fine and went home.
Two years later, in 2016, Dobbs was pregnant again. Because of her emergency C-section with Cameron, she was scheduled for another C-section and could plan the birth of her second child. She picked Feb. 8. It was two days before her own birthday. Dobbs was excited and felt prepared to welcome her first daughter, Claire, into the world.
Then came the uterine atony. During her C-section, her doctors said her uterus was “boggy” — it was soft, enlarged, floppy and would not contract as it was supposed to. It also wouldn’t stop bleeding.
Heather:Listen They were just bringing fluid after fluid, after fluid bag, and I finally said to myself: You cannot die on this table before you get to hold your daughter. And that’s the last thing I remember.
Claire was born healthy. But Dobbs’ postpartum hemorrhaging — as a result of uterine atony — forced the doctors to perform a full hysterectomy.
Heather:Listen And then, the doctor came in to talk about the hysterectomy with me. And, I just remember … you know how you watched Charlie Brown, and it’s like, womp womp womp womp womp womp. It’s like, what is she saying? I knew it was serious, but they had to eventually call her back in to re-explain. “You were bleeding out. You lost a tremendous amount of blood, and you had to … We had to take your uterus.”
The emotional toll of the hysterectomy and the complication that caused it led to postpartum depression. The support of her mother — Avis Glover, 63, a career nurse, who had two C-sections herself — has been important in her recovery.
Avis: How do you manage, you think, with the long-term effects of your experience?
Heather: Listen At my darkest hour, it was like why plan anything? Everything’s just going to go however it goes anyway. You don’t have any control, so that was really difficult. But then at the same time, it made me aware, you have two kids that you have to care for now. And in caring for them, you must care for yourself, so you can’t have the anxious mom, and the depressed mom, you have to treat it.
Fibroids are benign tumors in the uterus. They are most common in 30- to 40-year-old women. Fibroids, however, are three times more likely to occur in black women than white women. They also tend to occur at younger ages and grow more quickly in black women, causing more severe symptoms — like heavy menstrual bleeding and pelvic pain — contributing to complications such as postpartum hemorrhage.
Preeclampsia occurs when a woman with normal blood pressure develops high blood pressure during pregnancy and when protein is found in the urine. Left untreated, preeclampsia can lead to other serious complications for both the mother and the baby. Preeclampsia affects at least 5 to 8 percent of pregnancies. When black women have preeclampsia, it presents earlier than in women of other races.
Asha Ivey-Stephenson, 37, and Wanda Irving, 64, became friends through Wanda’s daughter, Shalon Irving. The three first met in Michigan in 2002 while Asha and Shalon visited graduate school programs they were interested in attending. Years later the friends reconnected in the Atlanta area where they both settled. Close in age, both wanted to become mothers. Ivey-Stephenson would be the first. She got pregnant in 2015 when she was 35 years old. Ivey-Stephenson has fibroids, a complication that affects 80 percent of black women. No one knows what exactly causes fibroids or why black women are so susceptible.
Ivey-Stephenson’s fibroids kept her in the high risk perinatal unit for a month and a half. Her stay was so long that Ivey-Stephenson had her baby shower at the hospital. In mid-December she delivered a healthy baby boy.
Asha:Listen This is something that Shalon and I actually bonded over. She helped motivate me through as well. My challenges that I was referring to primarily stemmed from my uterine fibroids and it’s something that African-American women deal with. The majority of my friends have, whether it’s small, large, multiple fibroids. It’s something that my mother had, so I knew that most likely I’d have it.
Five days after she delivered, just as she was about to leave the hospital, Ivey-Stephenson’s blood pressure skyrocketed.
Asha:Listen There were points where [my blood pressure] got so high, we were all not sure what was going to happen. When I got home, I had to have physical therapy, occupational therapy and regular nursing. Occupational therapy and regular nursing came to the house because I had lost so much muscle tone. Basically I couldn’t walk. So I had to learn all that over again. And it was just, trying to do that plus trying to breastfeed, trying to do all these different things was challenging.
During all of this, Irving was part of her network of supportive friends.
A little over a year later, in January 2017, Irving celebrated the birth of her first child — a baby girl she named Soleil. But Irving was a mother for just three weeks. Her postpartum complications became increasingly serious. She ultimately died due to complications from high blood pressure. Soleil was left in the care of Irving’s mother, Wanda. Ivy-Stephenson has stayed close to the family. Wanda sat down with Ivey-Stephenson to share this conversation, and her advice for other expectant black women.
Wanda:Listen My one regret is that Shalon told me once, she says, “I know my body. I know there’s something wrong,” and that’s what I would recommend to every black woman, if you know there’s something wrong, please don’t stop until you find someone who will help you figure out what’s wrong, and not just take a lot of the paternalistic kinds of answers or the general answers, “Oh well it’s nothing. It comes along with pregnancy,” or “It’s part of childbirth,” or it’s part of whatever. You know your body better than anyone else. You live in that body. If there is something you’re feeling that’s wrong, then do something.
A uterine rupture is a tear in the wall of the uterus. While rare, this complication is dangerous not just for the mother but for the child. When the uterus tears, the unborn baby can be expelled into his or her mother’s abdomen. The baby can be deprived of oxygen and the mother can experience severe blood loss. A well-known risk factor for a uterine rupture is a uterine scar. Most uterine scars arise from a prior cesarean delivery.
In March 2014, Heather Lavender was 32 and nine months pregnant when she went into labor. Her mother, Brenda Bagby, her sister, Melissa, her doula, and her son’s father rushed Lavender to Johns Hopkins Hospital in Baltimore where she was also an intensive care nurse.
After many hours of labor, she had a pain in her abdomen, which gradually became unbearable. That pain turned out to be a uterine rupture. After an emergency C-section to deliver the baby, doctors had to perform a hysterectomy to stop the massive blood loss.
Heather:Listen You know as long as my baby is OK, you know … God can’t be that cruel to have me lose my uterus and my baby all at the same time. So at that point I was just really hoping and praying that my son would be OK.
The rupture, however, was catastrophic for her son. Cruz ended up outside of the womb and without oxygen. As a result, he suffered severe brain damage. When Cruz was born he never moved, opened his eyes or cried.
Brenda: How are you different now than before your complication?
Heather:Listen I think for most of my life I’ve been a pretty positive person and I just don’t feel that way about myself anymore. I feel purposeless, I don’t feel that I have like true joy in my life, I don’t care. I pray for an early death. I don’t want to live to be an old person … and I know it’s wrong.
Cruz lived nine days on a ventilator in the neonatal intensive care unit before Lavender and her family decided to remove him from life support.
Heather: How do you remember my son Cruz, your grandson?
Brenda:Listen It’s hard sometimes, I couldn’t stand the sound of the machinery after a while. I just wanted it to stop, I didn’t want to hear more beeping. No more alarms. So I am glad we got to have a little bit of time without all of that. And when they extubated him, when they removed him from the breathing tube it was clear that he wasn’t going to be able to be with us for very long. So being able to go home and have that quiet time with him that we wouldn’t have had otherwise was really a blessing and having the pictures that we have from that helps me every day.
In 2016, Lavender moved from Baltimore, Maryland, to Farmington, New Mexico. This conversation was recorded during a visit from her mother who lives in Cleveland Heights, Ohio. Lavender continues to practice as a nurse.
Spontaneous coronary artery dissection, or SCAD, often occurs late in the pregnancy or during the postpartum period. It’s when a tear forms in one of the blood vessels in the heart. It can slow or block blood flow, causing a heart attack, abnormalities in heart rhythm or sudden death. Hormonal changes during pregnancy are thought to trigger this complication. Despite treatment, it may recur soon after the initial tear or even years later.
As in most SCAD cases, Candice Williams, a high school teacher, was healthy throughout her pregnancy. She was 30 at the time. She did not have a heart condition or a previous history of hypertension. But five days after giving birth to her first child, Aniston, in 2011, she nearly died.
Aniston is now 6 years old and wanted to ask her mother this:
Aniston: How did you get your heart attack?
Candice:Listen That’s a good question baby, doctors aren’t really sure. I’ve seen at least four doctors related to the heart attack and all they can tell me is that it is a rare occurrence and that it has something to do with my hormones so when I had you my hormones were unstable as women’s hormones are after they give birth so I guess that caused my heart to start hurting baby but it wasn’t your fault.
Williams, now 37, was home from the hospital when her chest started to hurt. The pain got so bad that her mother, LaVerne Maynard, rushed Williams to a nearby hospital in El Centro, California. Because that hospital wasn’t equipped to treat Williams, she was airlifted more than 100 miles to a hospital in San Diego.
LaVerne: What is the hardest moment for you?
Candice:Listen The hardest moment was probably being life-flighted and I only remember parts of it, I guess I was really scared and I kept thinking about Ani and if I … if something happened to me, I had no idea what was going to happen to my baby. So that was the hardest moment. It’s still the hardest moment.
After more tests, doctors concluded that she had experienced a SCAD. Rather than operate on her, they gave her blood thinners, beta blockers and aspirin to prevent another attack and help heal the heart on its own. She was hospitalized for four days and released.
Candice:Listen I had a relatively good diet, I was not overweight and SCAD often happens to women who don’t have any prior health issues. So people think because I had a heart attack that I had high blood pressure or I didn’t eat right or didn’t exercise but I was actually the opposite of that.
After surviving this SCAD, her doctors advised against a second pregnancy. But, five years later, in March of 2016, Williams gave birth to a second daughter, Leah. This time, she had no complications. Williams pays more attention to her body now. She takes blood pressure medication once a week, sees her cardiologists every six months, exercises, and watches what she eats.
Peripartum cardiomyopathy (PPCM) is a form of maternal heart failure. It’s when the heart isn’t strong enough to pump enough blood to the vital organs so they can function properly. A mother may experience PPCM up to six months postpartum. On average, PPCM affects black women at a younger age (27.6 years old) than non-black women (31.7 years old). And despite similar rates of treatment, the recovery time for African-American women was at least twice as longas that of other women. Little research has been done to understand the differences in severity and recovery.
In 1992, about a month after Anner Porter gave birth to her second child — a boy she named Norris — she was at the OB-GYN complaining of exhaustion and numbness. She said she was told to eat some beets to improve a low iron count. Two days later, Porter nearly died. Her heart failed to pump enough blood to keep her vital organs going. This is called postpartum cardiomyopathy (PPCM).
That was the first time Porter had heard of PPCM — from an emergency room doctor diagnosing it as her organs started to shut down. Ever since that postpartum heart failure 25 years ago, Porter has suffered heart complications.
Jennifer: Tell me what happened in the postpartum period that changed your life?
Anner:Listen Oh wow, OK. Twenty-eight days later I still found it extremely difficult to function. I was extremely fatigued. Was constantly experiencing shortness of breath. Coughing all the time unable to lie down, heart palpitations, I had significant weight gain, excessive swelling in my legs, belly, feet, ankles. I remember each day became unbearable and each night became a nightmare. At that point I knew something was wrong with my body.
In the years since the cardiomyopathy, she has needed two separate heart procedures: a defibrillator implanted in 2010, and open-heart surgery after a silent heart attack in 2012.
Anner: Do you look at your own life differently?
Jennifer:Listen Yes, I do. Seeing how something simple can — like childbirth — put so much stress on your body and seeing everything that you went through in terms of how you drastically had to change your diet, how you were going from no medication to five to six different medications, how your body reacted. Seeing how different stress in certain activities in life you couldn’t do in terms of like walking up the stairs, you couldn’t do. How little things like driving, you used to lose your breath and you used to have that plastic bag … not plastic … paper bag in your purse in case something happened, you had that, so yeah it has changed my life.
While the cause of PPCM remains unknown, Porter believes awareness among women and clinicians can save lives.
Anner:Listen I don’t want any other woman to experience a near-death pregnancy like I did, I feel that I must continue to bring awareness about this deadly disease that actually has no cure in sight.
These vignettes are snippets of hours-long conversations. The women talked with each other about their formative years, their painful memories of death or near death, and the advice they would give to expectant and new mothers. Often, what they heard from their loved ones surprised them.
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