The Washington PostDemocracy Dies in Darkness

A 15-year-old gave birth in D.C., then was taken off life support. Her case is why looking deeper than statistics matters.

The District’s maternal mortality rate is more than double the nation’s. A Maternal Mortality Review Committee — once the city forms it — will try to understand why.
The District’s maternal mortality rate is more than double the nation’s. A Maternal Mortality Review Committee — once the city forms it — will try to understand why. (iStock)
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When a 15-year-old girl born with HIV became pregnant, she decided to tell no one.

She hid her growing belly under her clothes. She stopped taking her medication.

No one knew about the baby until the teenager ended up at a Washington hospital with a severe case of strep throat. But by then, it was too late. Doctors could not stop the infection. When the baby was born at 31 weeks, the teenager was brain dead.

After the delivery, she was taken off life support.

That death happened in the nation’s capital, but you probably didn’t hear about it. I didn’t, either, until I went back recently to watch a recording of a public hearing that was held to discuss whether the city should create and fund a Maternal Mortality Review Committee.

What struck me about the girl’s story was not just the heartbreaking details of her death, but also that we wouldn’t know any of them if an obstetrician hadn’t decided to share them.

We would have known only this: One more new mom in D.C. had died.

That’s how maternal mortality has for too long been handled in the city — through statistics that provide us with just enough information to be concerned about the issue but not enough to do much about it.

What the numbers tell us: The District’s maternal mortality rate is more than double the nation’s, and among the maternal deaths recorded between 2014 and 2016 in Washington, 75 percent were of African American women.

What the numbers don’t tell us: why that volume and racial disparity exist.

We don’t know how these women died and what might have prevented those losses. We don’t know what these women’s lives were like before they became pregnant and what support they had once they found out they were pregnant.

We don’t know what they looked like or who misses them now.

When the city announced that it was creating and funding the Maternal Mortality Review Committee (MMRC), I commended the move in this column. That was in June, and I noted at the time that the funding was made available in the city’s October budget.

Why Washington is one of the worst places to be black and pregnant

Here we are now in February, and the committee still has not been formed, despite eager participants and an obvious need.

On Monday, the office of D.C. Council member Charles Allen (D-Ward 6) posted on Twitter a letter he sent on Jan. 9 to the chief medical examiner and the Mayor’s Office of Talent and Appointments. In it, he requested “an update on the status of the Mayor’s appointments” to the committee.

“The Committee has experienced a large outpouring of individuals who have expressed interest in serving on the MMRC, whose names and qualifications we have shared with OCME [Office of the Chief Medical Examiner],” reads the letter from Allen, who had introduced the bill to establish the committee. “The Committee and stakeholders are eagerly awaiting the appointments of the MMRC members so the MMRC can begin to meet.”

As of Friday, Allen’s office had not received a response. Requests that I made for information also went unanswered.

Constance Bohon, a obstetrician-gynecologist in the District who has been vocal about the need to examine maternal deaths, said she is among those chosen to sit on the committee. She said she initially received a letter saying she would be sworn in on Dec. 5. Then a week before that date, she got a notice telling her not to show up.

Bohon said she doesn’t know why the swearing-in ceremony was canceled or when it might now occur. But she said she’s eager to get to work and knows other committee members are as well.

“We’re just ready to take action,” she said. “This is an important issue we can’t ignore.”

Maternal deaths across the country vary each year, she said, but it’s not unusual for D.C. to rank toward the top.

“And we have to figure out why?” she said. “What is it we’re missing?”

A pregnant woman went to the ‘hospital from hell’ short of breath. Six hours later, she was dead.

Melissa Fries was the obstetrician who shared the teenager’s story at that earlier hearing. She said she had counted how many women had died in the 11 years she had worked at MedStar Washington Hospital Center, where she served as chair of Women’s and Infants’ Services. The number, she said, was 17. She described the teenager as one who stood out to her.

“To me, that puts a face on every single case we deal with,” she said.

Faces, not statistics. The District is long overdue for looking at the issue in that way. The city was smart to fund the committee. Now, let us hope it will move quickly to form it and let the members get to work.

Too many women’s stories are known to us right now only as numbers.

At that hearing, another obstetrician, Serina Floyd, spoke about a patient she called “Donna.”

Donna was a 29-year-old mother of a 3-year-old girl when she went in for a scheduled Caesarean section to deliver twins.

Floyd said the first of the two babies was born without complications. But after the second was delivered, Donna had a seizure. Her heart then stopped. Frantic efforts were made to save her, Floyd said, but she died on the operating table.

“What was the most heartbreaking for me was attending her memorial service,” Floyd said. “As I sat and listened to her loved ones talk about her life, I looked over at her husband, sitting next to her 3-year-old, holding one of her newborn twins while her mother held the other.”

No one, she said, can fully understand what that loss meant to her husband or to her children, “two of whom never got to meet her.”

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