Three weeks after Cassaundra Lynn Perkins gave birth to premature twins, she returned
to the hospital, feeling unwell. She phoned her mother from her hospital bed at
3:30 in the morning. "I'm just not feeling good," she said. Surely it was just another
bout of the mysterious illness her daughter had been suffering from for most of
her pregnancy, Cheryl Givens-Perkins thought as she rushed over to San Antonio's
North Central Baptist Hospital. When Givens-Perkins walked into the room, her
daughter looked exhausted. She begged her mother to comb her hair. "I need to get
ready," she said. "Please get my hair in order." "She may have known she was dying,"
Every year, around 700 women in the United States die as a result of pregnancy or
delivery complications. As many as 60,000 expectant mothers suffer problems that
come close to costing them their lives. America is one of the most developed nations
in the world. Average life expectancy has been generally increasing over at least
the last five decades, and deaths from illnesses that were once widely fatal, including
polio, smallpox, tuberculosis and AIDS, are sharply falling.
Yet when it comes to the natural process of childbearing, women in the U.S. die
in much higher numbers than those in most developed nations, where maternal deaths
are generally declining.
A woman in the U.S., where the maternal death rate more than doubled between 1987
and 2013, is more likely to die from pregnancy-related causes than in any country
but Mexico among the 31 industrialized countries of the Organization for Economic
Cooperation and Development that reported data.
There are various theories why persistent poverty, large numbers of women without
adequate health insurance, risk factors related to stress and discrimination. All
come together here in Texas, with a twist that has become one of America's most
confounding public health problems: African American women are dying of pregnancy-
and childbirth-related causes here at stunningly high rates. The maternal death
rate in Texas after 2010 reached "levels not seen in other U.S. states," according
to a report compiled for the American College of Obstetricians and Gynecologists,
based on figures from the U.S. Centers for Disease Control and Prevention.
Black women in Texas are dying at the highest rates of all. A 2016 joint report
by the Texas Department of State Health Services' Maternal Mortality and Morbidity
Task Force found that black mothers accounted for 11.4% of Texas births in 2011
and 2012, but 28.8% of pregnancy-related deaths. "This is a crisis," said Marsha
Jones, executive director of the Afiya Center, a Dallas-based nonprofit that has
taken on the issue. In May, the center published its first report: "We Can't Watch
Black Women Die."
Perkins, who already had a 2-year-old, worked at Great Clips salon and hoped to
one day open her own salon. Her pregnancy with twins in 2014 was challenging. "She
was sick to where she could not keep anything down," Givens-Perkins said. Doctors
said it was an infection. Then six months into her pregnancy, Perkins' liver started