Serena Williams had to push for treatment for life-threatening postnatal complication

The headline of one of ProPublica’s recent articles in an excellent and devastating series on maternal health in the United States reads: “Nothing Protects Black Women From Dying in Pregnancy and Childbirth.”  The subtitle continued: “Not education. Not income. Not even being an expert on racial disparities in health care.” You can apparently add to that: Not even being the greatest athlete in the world. 

A cover story in Vogue yesterday recounted Serena Williams’ harrowing childbirth experience, in which she had to insist health care providers perform a CT scan to check for a pulmonary embolism when she suddenly began to have trouble breathing:

Though she had an enviably easy pregnancy, what followed was the greatest medical ordeal of a life that has been punctuated by them. Olympia was born by emergency C-section after her heart rate dove dangerously low during contractions. The surgery went off without a hitch; Alexis cut the cord, and the wailing newborn fell silent the moment she was laid on her mother’s chest. “That was an amazing feeling,” Serena remembers. “And then everything went bad.”

The next day, while recovering in the hospital, Serena suddenly felt short of breath. Because of her history of blood clots, and because she was off her daily anticoagulant regimen due to the recent surgery, she immediately assumed she was having another pulmonary embolism. (Serena lives in fear of blood clots.) She walked out of the hospital room so her mother wouldn’t worry and told the nearest nurse, between gasps, that she needed a CT scan with contrast and IV heparin (a blood thinner) right away. The nurse thought her pain medicine might be making her confused. But Serena insisted, and soon enough a doctor was performing an ultrasound of her legs. “I was like, a Doppler? I told you, I need a CT scan and a heparin drip,” she remembers telling the team. The ultrasound revealed nothing, so they sent her for the CT, and sure enough, several small blood clots had settled in her lungs. Minutes later she was on the drip. “I was like, listen to Dr. Williams!”

Williams’ medical saga continued, leaving her bedridden for six weeks, and ultimately turned out ok. But the fact that Serena Williams, who’d nearly died of a pulmonary embolism in 2001, who had just had a C-section which increases the risk of blood clots, and who is Serena goddamn Williams, who is rich and famous and is rich and famous specifically for the spectacular feats of her body, had to identify her symptoms herself and demand the screening needed for a potentially deadly complication is an incredible illustration of the deep sexism and racism that black women face in the medical system.

The ProPublica series, by Nina Martin and NPR’s Renee Montagne, has been exploring the myriad factors that contribute to the US’ shameful record on maternal health. The US has the highest rate of maternal mortality in the developed world, and there is an enormous racial disparity: black women are three to four times more likely to die than white women. And while pre-existing health conditions and lack of access to medical care are part of the problem, they aren’t the whole story. As Dr Elizabeth Howell tells the New York Times today, “Everyone always wants to say that it’s just about access to care and it’s just about insurance, but that alone doesn’t explain it.”

It is also about health care providers who, in their focus on the baby after a delivery, too often overlook serious complications in the mother and who too often just don’t listen to women’s—especially women of color’s—testimony of their symptoms. Not even a world-famous athlete’s.