- Dr. Chaniece Wallace, a pediatric chief resident in Indiana, died after developing pre-eclampsia the day her daughter was delivered prematurely via C-section.
- Pre-eclampsia is thought to be one of the most preventable pregnancy complications, but rates are higher, and the prognosis worse, among Black women.
- Black women are at least 2.5 times as likely to die in childbirth than white women, with one estimate showing rates among college-educated Black women are 5.2 times that of white women.
- Experts say implicit bias in the medical system and a culture that discourages Black families from play into the tragic disparities.
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Dr. Chaniece Wallace, a pediatric chief resident at Indiana University School of Medicine, dedicated her career to caring for young lives. She was excited to use that gift in her personal life too, as she and her husband were expecting a daughter due November 20.
“We had discussed all of the many possibilities of her bright future and the limitless paths she could follow,” Wallace’s husband, Anthony Wallace, wrote on a GoFundMe page, adding that his wife “had a special way of being empathetic with her patients and making each one of them feel special.”
But Wallace never got that chance, dying in childbirth after their daughter, named Charlotte Azaela, was born prematurely via C-section, Anthony Wallace wrote Monday. Wallace had developed pre-eclampsia, a pregnancy complication characterized by high blood pressure that’s more common in Black women.
“Chaniece fought with every piece of strength, courage, and faith she had available,” Anthony Wallace wrote.
Wallace’s death has roiled both the local and national medical community, with colleagues demanding change to a healthcare system in which maternal mortality rates are at least 2.5 times higher in Black women than white women.
The GoFundMe page, which supports Anthony Wallace and Charlotte, who remains in the neonatal intensive care unit but is “doing exceptionally well,” has already raised more than $76,000. The goal was $5,000.
—Shawnté #BLM James, MD 😷 (@ShawnteJamesMD) October 26, 2020
—Rachel Vreeman, MD, MS (@rachelvreeman) October 27, 2020
Pre-eclampsia, one of the most preventable causes of maternal death, disproportionately affects Black women
According to the GoFundMe page, Wallace developed symptoms of preeclampsia on October 20, the same day her daughter was born. Over the next two days, she underwent surgery and experienced a ruptured liver, high blood pressure, and poorly functioning kidneys, Anthony Wallace wrote.
Pre-eclampsia, a condition Beyonce also had, causes women to develop high blood pressure and usually protein in her urine, and can also lead to swelling in their legs, hands, face, or whole body, according to Harvard Medical School. If it develops into eclampsia, women experience seizures and may be at higher risk of stroke.
“In parts of the world with more limited medical care, preeclampsia and eclampsia cause many women to die during pregnancy,” the Harvard website says. “Fortunately, with appropriate prenatal care and monitoring, most women with preeclampsia and eclampsia and their babies survive just fine.”
But the outlook is bleaker for Black women in America, whose rates of pre-eclampsia and eclampsia are about 60% higher than white women, and who are more likely to experience poor outcomes from the condition, one 2017 report out of the US Agency for Healthcare Research and Quality found.
Racial disparities persist in maternal mortality rates
In the US, Black women are at least two and a half more likely to die in pregnancy, childbirth, or immediately postpartum than white women. Other statistics show pregnancy-related deaths for Black, American Indian, and Alaska Native women over 30 years old are four to five times as high as they are for white women.
The pregnancy-related mortality ratio for black women with at least a college degree is 5.2 times that of white women, the same data, out of the Centers for Disease Control and Prevention found.
Doctors and researchers have pointed to a variety of factors that could help explain the outcomes, including socioeconomic status and access to prenatal treatment, but as a physician, Wallace’s death highlights other factors, like racial bias in the medical system.
“To this day, Black people are less likely to get the same treatment in terms of pain medication, they’re more likely to wait longer in the ER, they’re less likely to be taken seriously — it’s a holdover from the days of slavery,” Dr. Jennifer Lincoln, an OB-GYN, said on TikTok in response to the death of Nicole Thea, a London-based social media star, who died July 11 along with her unborn child at 8 months pregnant.
Lincoln highlighted a study showing that 50% of doctors and residents surveyed falsely believe Black people experience pain differently than white people, leading to inappropriate treatment.
Sayida Peprah, a psychologist and doula, previously told Insider implicit bias in the medical system can also play out when a Black mother is dismissed when she raises a concern, a Black father is dissuaded from asking questions because the healthcare providers perceive him as hostile, or a clinician puts less effort into caring for a Black infant or mom due to “unconscious influences around the lack of value of their lives.”
In her TikTok, Lincoln told healthcare professionals “check your implicit bias” and urged women of color to speak up if they feel they’re not getting appropriate care.
“If this is happening to you, ask to speak to a different nurse, a different doctor, report them, speak up,” she said.