THE NEW YORK TIMES, SUNDAY, AUGUST 9, 2020 MB 5pressure, died during an emergency C-sec-
tion at Woodhull, a public hospital in Brook-
lyn. According to her family, doctors rushed
Ms. Washington to an operating room after
they gave her an epidural, which she had
felt pressured to accept. The baby survived,
but Ms. Washington died of a heart attack. A
representative from Woodhull declined to
comment on the case.
The swift shift from in-person visits to
telemedicine has allowed more vulnerable
women to slip between the cracks. In April,
Amber Rose Isaac, a 26-year-old Black
woman, died after an emergency C-section
at Montefiore Medical Center in the Bronx.
According to Bruce McIntyre, Ms. Isaac’s
boyfriend, she had been complaining of se-
rious fatigue and shortness of breath, but
her obstetrician seemed to dismiss her con-
cerns, and Ms. Isaac had trouble getting an
in-person visit.
Frustrated with her care, Ms. Isaac tried
to arrange to deliver at home or at a birthing
center, but after scanning her medical
records, a midwife told Ms. Isaac her plate-
let levels were dangerously low, putting her
at high risk because her blood wasn’t able to
form clots easily. “This was news to us,” Mr.
McIntyre said. “At least five doctors signed
off on Amber’s paperwork while her platelet
levels were dropping, and nobody told us.
They didn’t see us in March at all.”
When Ms. Isaac came to the hospital for
an appointment on April 18, doctors held
her for days and then induced labor on April
20, more than a month before she was due.
During emergency surgery, Ms. Isaac bled
to death, partly owing to her low platelet
levels, Mr. McIntyre said, but her son sur-
vived. Mr. McIntyre accuses the hospital of
negligence: “She was voicing her concerns
all the time and no one would listen to her.”
A Montefiore spokeswoman said privacy
laws prohibited comments on specific pa-
tients.
“The hospitals that have been most over-
whelmed by the pandemic are the same
hospitals that Black and brown women in
New York City are predominantly giving
birth in,” said Mary-Ann Etiebet, a New
York-based physician and director of Merck
for Mothers, the pharmaceutical company’s
initiative to address maternal mortality. Dr.
Etiebet volunteered at a Brooklyn public
hospital during the height of the pandemic
and saw for herself the “huge operational
burden” of increasing intensive-care capac-
ity “fivefold in two weeks.”
Despite these inequities, the state’s latest
budget bill, signed by Gov. Andrew M.
Cuomo in April, includes $138 million in
Medicaid cuts to the city’s public hospitals,
which mostly serve Black and Latino resi-
dents.
Yet hospital quality cannot be blamed
solely for the city’s racial disparities. A
study published earlier this year in the jour-
nal Obstetrics and Gynecology found that
even when Black and Latina women gave
birth in the same New York City hospitals as
white women, and had similar insurance,
they were still more likely to experience a
life-threatening complication than white
mothers. Across the city, the risk of a near-
death experience was 52 percent higher for
Black mothers and 44 percent higher for La-
tinas than white women, regardless of in-
surance and after adjusting for other risk
factors, such as diabetes and hypertension.
A 2016 citywide study found that Black
women with a college degree were more at
risk of a near-fatal childbirth emergency
than women of other races who had never
graduated high school.
“America has the worst maternal-health
problems in the developed world, and
there’s no way to understand this without
putting racism front and center,” said Neel
Shah, an assistant professor of obstetrics,
gynecology and reproductive biology at
Harvard Medical School. He noted that phy-
sicians had been “medicalizing blackness”
since the end of the Civil War, explaining
health problems as a consequence of physi-
ology and personal choices rather than as a
product of poverty or racism.
Studies have shown that health providers
consistently underestimate complaints of
pain in Black patients as compared with
white ones. And according to Dr. Shah, the
algorithms hospitals use to manage care for
patients also tend to weigh the needs of
Black and white people differently. In ob-
stetrics, for example, hospitals regularly
tell Black women they are less likely than
white women to have a successful vaginal
delivery after a C-section, regardless of
other details. “The accumulation of all of
this is that Black people get less care,” Dr.
Shah said.
In mid-April, nearly three weeks after
Chrissy Sample lost one of her twins, she
was home with her son in Bedford-
Stuyvesant, Brooklyn, when she began feel-
ing intense pains. “I had been so condi-
tioned to discomfort that I didn’t know what
was alarming,” she said. She was sitting on
her bed when she heard a popping sound
and began bleeding profusely.
Her husband, who is a lieutenant for the
city’s Police Department, rushed home and
sped her to the hospital, where she deliv-
ered her surviving twin in an emergency ce-
sarean section. For nearly two months, Ms.
Sample’s newborn, Cassius, remained in
the hospital’s neonatal intensive-care unit.
When he was born, he weighed less than
three pounds, but on June 6, Ms. Sample
brought him home. “He’s a fighter,” she said.
“He earned his name.”
Ms. Sample, who has private health in-
surance through her husband’s job, had as-
sumed she lost one of her babies because
her obstetrician had been inattentive and
Covid-19 was making care harder for every-
one. But after talking to friends, she began
wondering if her problems had to do with
the fact that she is Black.
“Friends kept telling me that when you’re
a Black woman, you really have to find a
way to get people to listen when you’re in
pain,” Ms. Sample said. Her obstetrician,
who is white, has since assured her that the
throbbing soreness around her C-section
scar is normal, but Ms. Sample said she
found it hard to trust her now.
Women of color who worry about their
care often seek out health workers who look
like them. After an uncomfortable experi-
ence with a white obstetrician, Laz Davis, a
38-year-old Brooklyn woman pregnant with
her first child, decided to have a home birth
with a Black midwife and a Black doula in
late June, even though her insurance did
not cover an out-of-hospital birth.
“In this country, you never know if the
way you’re treated is because you’re Black
or the person is a jerk,” Ms. Davis said. “I’ve
learned how to advocate for myself, but
sometimes I don’t want to have to be strong.
Sometimes I just want to be nurtured.”
Emilie Rodriguez, a Bronx-based doula
and founder of Ashe Birthing Services, has
noticed that health care providers typically
treat her Black and white clients differently
— a contrast confirmed last year by a na-tionwide study in the journal Reproductive
Health. Ms. Rodriguez has found that
nurses and doctors are often more respon-
sive when a white mother complains about
pain or expresses concern about a pro-
cedure. When a mother is Black, however,
providers are quicker to judge her as “non-
compliant,” she said, adding, “I’ve almost
lost two Black clients in hospitals because
they were ignored.”
Dr. Shah, the Harvard obstetrics profes-
sor, said he was concerned that new hospi-
tal policies that limited visitors had made it
harder for pregnant women to secure the
advocacy they need. “We have extremely
good data that show that an advocate, par-
ticularly a professional one, improves out-
comes,” he said. “On the margin, it can even
be lifesaving, particularly for mothers with
less agency to begin with.”
Simone Colbert, a doula based in Brook-Black, Pregnant and in Greater Peril
CONTINUED FROM PAGE 1
PHOTOGRAPHS BY FLO NGALA FOR THE NEW YORK TIMESTop, Emilie Rodriguez, a doula
and founder of Ashe Birthing
Services in the Bronx. Above,
Bruce McIntyre and Elias, the
son of his girlfriend Amber
Rose Isaac, who died after an
emergency C-section in April.lyn who often works with low-income wom-
en of color, recently supported a 19-year-old
Black mother at a public hospital in the bor-
ough over speakerphone. Ms. Colbert
sensed the hospital was rushing this wom-
an, who ended up having an emergency C-
section, but she felt there was little she
could do without being physically in the
room.
“I was on the phone trying to make sure
she was asking the right questions,” she
said, “but I’m not there to talk to the nurses.
It’s so hard.”
All across the city, hospitals are reporting
higher rates of inductions and C-sections, as
well as an uptick in premature babies for
Black and Latino mothers, said Sascha
James-Conterelli, president of the New
York State Association of Licensed Mid-
wives and a chairwoman of the state’s Task
Force on Maternal Mortality and Disparate
Racial Outcomes. What the pandemic did,
she said, is “underscore the disparities that
already existed.”
In April, Sophia Louis, a Black doula in
the Bronx, became so concerned about
Black and brown expectant and new moth-
ers during the pandemic that she began of-
fering free counseling through her Insta-
gram account. One woman sought help be-
cause she had no idea how to care for her
third-degree perineal tear. She used her
cameraphone to show her stitches, and Ms.
Louis noticed what seemed to be an infec-
tion and pushed her to call her provider,
who prescribed antibiotics.
“Because of the pandemic, mothers are
being discharged so quickly that they don’t
have proper information about how to care
for their wounds, or how to breastfeed prop-
erly,” Ms. Louis said. Many women did not
get lactation support in the hospital, and
their babies are not gaining enough weight.
Other mothers are showing signs of anxiety
or depression, which Ms. Louis believes
have become more common because the
women are isolated from friends and family.
The social isolation, together with the
loss of her son, has been hard on Ms. Sam-
ple. “First there were no baby showers,
then there was no baby,” she said. “It’s just a
sad time.” She marvels at her son Cassius,
who has been growing steadily ever since
she got lactation support. But she mourns
the twin she never really got to meet, whom
she named Apollo.
Ms. Sample wishes she could warn other
women — especially Black women — about
the challenges of being pregnant during a
pandemic. “It’s scary; you end up feeling re-
ally alone,” she said. “I would hate for this to
happen to anyone else.”Elegant apartments, exquisite dining venues, exceptional amenities
and impeccable service all set the new standard for senior living
on Long Island. Live a life well-deserved at Encore Luxury Living.Live year-round, or take advantage of our short-term
stay options. Fully furnished turnkey apartments
are available for both.AN ENGEL BURMAN COMMUNITY Equal Housing OpportunityA SENIOR RENTAL COMMUNITY516.219.9390 | encoreluxuryliving.com
300 Jericho Turnpike, Jericho, NY 11753CALL FOR MORE INFORMATION OR TO SCHEDULE A TOURLONG ISLAND LIVING
LIKE NEVER BEFORE
Sherbee
Antiques
LIC./Bonded Est. 1947
ANTIQUES,
JEWELRY &
SILVER WANTED
Antiques, Silver,
Paintings,
Porcelain, Bronze &
Marble Statuary,
Objects of Virtue.PREMIUM PRICES
PAID
Please call(718) 762-7448
Andrew Korman, ProprietorAnnouncing
AnnouncementsCelebrate births,
engagements, weddings,
anniversaries and
more in The Times.
Call 1-800-238-4637.StIlL
tHe oNe