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HOUSTON — Tonjanic Hill was overjoyed in 2017 when she learned she was 14 weeks pregnant. Despite a history of uterine fibroids, she never lost faith that she would someday have a child.
But, just five weeks after confirming her pregnancy, and the day after a gender-reveal party where she announced she was having a girl, she seemed unable to stop urinating. She didn’t realize her amniotic fluid was leaking. Then came the excruciating pain.
“I ended up going to the emergency room,” said Hill, now 35. “That’s where I had the most traumatic, horrible experience ever.”
An ultrasound showed she had lost 90% of her amniotic fluid. Yet, over the angry protestations of her nurse, Hill said, the attending doctor insisted Hill be discharged and see her own OB-GYN the next day. The doctor brushed off her concerns, she said. The next morning, her OB-GYN’s office rushed her back to the hospital. But she lost her baby, Tabitha Winnie Denkins.
“This is a public health crisis as it relates to Black moms and babies that is completely preventable,” said Barbie Robinson, who took over as executive director of Harris County Public Health in March 2021. “When you look at the breakdown demographically — who’s disproportionately impacted by the lack of access — we have a situation where we can expect these horrible outcomes.”
In fact, Harris County ranks third, behind only Chicago’s Cook County and Detroit’s Wayne County, in what are known as excess Black infant deaths, according to the federal Health Resources and Services Administration. Those three counties, which also are among the nation’s most populated counties, account for 7% of all Black births in the country and 9% of excess Black infant deaths, said Ashley Hirai, a senior scientist at HRSA. That means the counties have the largest number of Black births but also more deaths that would not occur if Black babies had the same chance of reaching their 1st birthdays as white infants.
No known genetic reasons exist for Black infants to die at higher rates than white infants. Such deaths are often called “deaths of disparity” because they are likely attributable to systemic racial disparities. Regardless of economic status or educational attainment, the stress from experiencing persistent systemic racism leads to adverse health consequences for Black women and their babies, according to a study published in the journal Women’s Health Issues.
These miscarriages and deaths can occur even in communities that otherwise appear to have vast health resources. In Harris County, for example, home to two public hospitals and the Texas Medical Center — the largest medical complex in the world, with more than 54 medical-related institutions and 21 hospitals — mortality rates were 11.1 per 1,000 births for Black infants from 2014 through 2019, according to the March of Dimes, compared with 4.7 for white infants.
The abundance of providers in Harris County hasn’t reassured pregnant Black patients that they can find care that is timely, appropriate or culturally competent — care that acknowledges a person’s heritage, beliefs and values during treatment.
Regardless of income or insurance status, studies show, medical providers often dismiss Black women’s questions and concerns, minimize their physical complaints and fail to offer appropriate care. By contrast, a study of 1.8 million hospital births spanning 23 years in Florida found that the gap in mortality rates between Black and white newborns was halved for Black babies when Black physicians cared for them.
In 2013, Houstonian Kay Matthews was running a successful catering business when she lost the daughter she’d named Troya eight months and three weeks into pregnancy.
Matthews hadn’t felt well — she’d been sluggish and tired — for several days, but her doctor told her not to worry. Not long afterward, she woke up realizing something was terribly wrong. She passed out after calling 911. When she woke up, she was in the emergency room.
None of the medical staffers would talk to her, she said. She had no idea what was happening, no one was answering her questions, and she started having a panic attack.
“It kind of felt like I was watching myself lose everything,” she recalled. She said the nurse seemed annoyed with her questions and demeanor and gave her a sedative. “When I woke up, I did not have a baby.”
Matthews recalled one staffer insinuating that she and her partner couldn’t afford to pay the bill, even though she was a financially stable business owner, and he had a well-paying job as a truck driver.
She said hospital staffers showed minimal compassion after she lost Troya. They seemed to dismiss her grief, she said. It was the first time she could remember feeling as if she was treated callously because she is Black.
“There was no respect at all, like zero respect or compassion,” said Matthews, who has since founded the Shades of Blue Project, a Houston nonprofit focused on improving maternal mental health, primarily for Black patients.
To help combat these high mortality rates in Harris County, Robinson created a maternal child and health office and launched a home-visit pilot program to connect prenatal and postpartum patients with resources such as housing assistance, medical care and social services. Limited access to healthy food and recreational activities are barriers to healthy pregnancy outcomes. Studies have also shown a connection between evictions and infant mortality.
For Hill, not having insurance was also likely a factor. While pregnant, Hill said, she had had just a single visit at a community health center before her miscarriage. She was working multiple jobs as a college student and did not have employer-provided medical coverage. She was not yet approved for Medicaid, the state-federal program for people with low incomes or disabilities.
Texas has the nation’s highest uninsured rate, with nearly 5 million Texans — or 20% of those younger than 65 — lacking coverage, said Anne Dunkelberg, a senior fellow with Every Texan, a nonprofit research and advocacy institute focused on equity in public policy. While non-Hispanic Black Texans have a slightly better rate — 17% — than that overall state level, it’s still higher than the 12% rate for non-Hispanic white Texans, according to census data. Health experts fear that many more people are losing insurance coverage as COVID-19 pandemic protections end for Medicaid.
Without full coverage, those who are pregnant may avoid seeking care, meaning they skip being seen in the critical first trimester, said Fatimah Lalani, medical director at Houston’s Hope Clinic.
Texas had the lowest percentage of mothers receiving early prenatal care in the nation in 2020, according to the state’s 2021 Healthy Texas Mothers and Babies Databook, and non-Hispanic Black moms and babies were less likely to receive first-trimester care than other racial and ethnic groups. Babies born without prenatal care were three times as likely to have a low birth weight and five times as likely to die as those whose mothers had care.
Hill’s twins, though premature, are now preschoolers. “I believe God — and the high-risk doctor — saved my twins,” she says.(Brandon Thibodeaux/KFF Health News)
If Hill’s miscarriage reflects how the system failed her, the birth of her twins two years later demonstrates how appropriate support has the potential to change outcomes.
With Medicaid coverage from the beginning of her second pregnancy, Hill saw a high-risk pregnancy specialist. Diagnosed early with what’s called an incompetent cervix, Hill was consistently seen, monitored and treated. She also was put on bed rest for her entire pregnancy.
She had an emergency cesarean section at 34 weeks, and both babies spent two weeks in neonatal intensive care. Today, her premature twins are 3 years old.
“I believe God — and the high-risk doctor — saved my twins,” she said.
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF. It has been published with permission.
。    A recent in-flight medical emergency highlighted how traditional Chinese medicine techniques can complement emergency care in unexpected settings.    Four faculty members from the Beijing University of Chinese Medicine responded to a medical emergency aboard an overnight Air China flight from Paris to Beijing, using a combination of conventional assessments and TCM therapies to help an 11-year-old passenger whose condition later stabilized.    At about 3 am Beijing time on July 20, cabin crew issued an urgent call for medical assistance after the Chinese girl, who was returning from a performance in France, developed chest pain, alarming her family.    Four BUCM faculty members immediately came forward: Wang Ting, the university's vice-president; An Chao, deputy director of the International Cooperation Department; Chen Younan, associate dean of the School of Acupuncture-Moxibustion Tuina; and Zheng Fengjie, dean of the School of Traditional Chinese Medicine.    After checking the girl's blood pressure, body temperature and heart rate, they identified persistent pain in the chest area as her primary symptom.    The team administered oxygen and placed a TCM pill under the girl's tongue to promote blood circulation and relieve pain.    They also applied acupressure and massage techniques, focusing on several acupoints including Neiguan, located on the inner forearm about two to three finger widths above the wrist crease, between the tendons of the palmaris longus and flexor carpi radialis muscles.    According to TCM theory, stimulating the Neiguan acupoint is believed to help regulate heart function, calm the mind and relieve chest discomfort.    Working in the cramped cabin, the four physicians took turns kneeling beside the girl while monitoring her condition. Her chest pain gradually subsided. After the aircraft landed in Beijing, the crew arranged for ground medical personnel to continue her treatment. Later reports revealed that her condition had stabilized.    Wang said the emergency response demonstrated that TCM can play a role in certain acute situations when used alongside standard medical assessments.    "The treatment combined sublingual administration of a traditional Chinese medicine pill with acupressure techniques," he said. "Together, they helped relieve the child's symptoms by promoting blood circulation and easing the chest pain."    He added that many people associate TCM mainly with chronic disease management and health maintenance, while overlooking its potential applications in emergency situations.    "Herbal medicine, acupuncture and tuina are not limited to long-term care," Wang said. "We hope more people, both in China and abroad, will gain a better understanding of the role traditional Chinese medicine can play in emergency care."    The July incident was not the first time faculty members and students from BUCM provided medical assistance aboard flights.    On June 28, 2024, doctoral student Cao Feng used acupuncture to help revive a woman who had lost consciousness aboard a flight from Beijing to Lanzhou in Gansu province.    And on Oct 9, 2024, student Gao Yingjun administered acupressure to assist a Russian passenger suspected of having a stroke on a flight from the Maldives to Shanghai.    More recently, on Jan 1 this year, doctoral student Yang Yao used acupuncture on the Neiguan acupoint to help treat a passenger experiencing a hypertensive emergency aboard a China Eastern Airlines flight.    For the university, these incidents illustrate how medical professionals trained in TCM can contribute when emergencies arise unexpectedly, even thousands of meters above the ground.                    。

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