Tori Bowie, a 32-year-old Olympian, tragically passed away during childbirth in early May. The most horrifying aspect, she was alone, suffering from preeclampsia, and succumbed to it during early labor in her home.
As doulas, we know the US has a horrifyingly high maternal morbidity and mortality rate for a developed nation. We also know the risk of death related to pregnancy and childbirth is three to four times higher for black women. This is true even when we adjust for health, socioeconomics, education, and more.
It is widely accepted among professional organizations such as the CDC, ACOG, and the WHO that systemic racism and structures impact disparities in birth.
What does the tragic death of Tori Bowie mean for doulas and birth workers?
What We Know About Tori Bowie
Tori Bowie passed away in her home in early May. After reports from the medical examiner, it was determined she was eight months pregnant and passed away from complications related to childbirth.
Medical examiner Chantel Njiwaji cited possible complications including respiratory distress and eclampsia.
Eclampsia is a hypertensive disorder of pregnancy, like preeclampsia. However, when preeclampsia becomes eclampsia, extremely high blood pressure, seizures, and strokes are possible.
While we are not certain the exact causes of preeclampsia and eclampsia, we are sure of the clinical presentations and how to manage these conditions. The severe danger of these conditions is well documented.
What Do Doulas Need to Know About Tori Bowie?
As doulas, we know this is a tragedy. We know preeclampsia and eclampsia are well known complications of pregnancy. During the final trimester of pregnancy, patients see their providers for regular blood pressure checks as one way to catch early signs of these conditions.
As doulas, we are not medical providers. However, we are a resource and provide education to clients about topics related to pregnancy and childbirth.
Tragically, Tori passed away alone, in her own home. Because of this, we cannot speculate where something was missed or whether she lacked support and resources. Did she have high blood pressure reading at her last appointment? Perhaps the symptoms hit suddenly, and she had no time to call? Did she call a provider and end up brushed off?
As we do not have information there, we should not speculate. However, what we can do is understand that her tragic death is a possible symptom of issues within maternity care in the US.
It is important to understand that Black women in the US are 3-4 times more likely to pass away from pregnancy and childbirth related complications. This is true even when adjusted for income, education levels, support, etc.
As an Olympian, we can likely assume Tori Bowie was well educated about her body. We can likely assume she is knowledgeable, did not live in poverty, and had access to medical care. Yet tragically, she still passed away due to childbirth complications.
For doulas, this is a reminder that we can provide education about red flag symptoms. We can teach and empower clients, especially our clients of color, to be self-advocates during their care. It is a reminder to help our clients have an ‘emergency’ plan for when they may not be feeling right but are perhaps home alone.
Do Doulas Improve Birth Outcomes?
It is important to note that doulas are neither responsible for or capable of fixing the maternal health crisis in the US. In fact, in many ways, doulas are like a Band-Aid for a very broken system.
That said, research shows and supports that doulas can and do improve the chance of positive and safe birth outcomes for their clients. This can be especially impactful for BIPOC individuals, marginalized communities, and those suffering from poverty as all these groups are impacted by systemic biases in care.
“Women of color and those in areas of high poverty face persistent inequities in birth outcomes. Doula support during pregnancy and childbirth is associated with improvements in many outcomes, including lower rates of cesarean section and preterm birth, higher rates of breastfeeding initiation, and increased satisfaction with the birth experience.” (Thomas et al. 2017)
As a doula, you can focus on each client and help them feel supported, educated, and empowered.
Are you looking to understand more about supporting clients? Be sure to take our Diversity, Equity, and Inclusion For Birth Workers course.
Author: Maria Silver Pyanov, CPD, CCE
Maria Silver Pyanov, CPD, CCE has been serving prenatal and postpartum families since 2007.