CINCINNATI — Kandace Walters said she feels lucky to be alive.
“Kept hearing the blood pressure monitor go off, and it was kind of signaling that something was wrong,” Walter said.
Nine days earlier, Walters had given birth to a beautiful daughter.
“I just woke up, and I felt this immense pressure. I wasn’t sure what it was, but I just knew it wasn’t normal,” she said. “When I would walk up the stairs I was kind of out of breath.”
She thought it was nothing, but her husband encouraged her to call her doctor. Two minutes later her doctor called her back and told her to get to the ER.
Walters said it felt like a small dog was sitting on her chest, but she didn’t expect to hear any major news. She said she just thought she had elevated blood pressure, something her doctor verified.
“Things just didn’t look like regular preeclampsia or textbook preeclampsia with Kandace, and so that’s when we involved our cardiology team and evaluated her and realized she had a coronary dissection,” said Dr. Kimberly Russell with Christ Hospital.
A coronary dissection is when the coronary arterial wall separates and could lead to death.
“It’s very rare. Risk factors are having babies being in the postpartum period, having elevated blood pressure, so she did have some risk factors for it. I hadn’t seen it before,” Russell said.
Walters has three other children, but this pregnancy was different. She developed congenital diabetes, which led to her needing to be induced.
She also researched Black maternal mortality, so she knew it was higher for Black women.
“When I met Dr. Russell I had never seen her, except for the day she delivered me. I just told her I said, ‘You know, I need you to see me, I need you to keep an eye on me. I’m nervous. I know Black mortality rates are high, and I just need you.’ And she said, ‘I got you,’” Walters said.
The Centers for Disease Control and Prevention reports Black women are three times more likely to die from pregnancy-related complications.
Russell said that’s an unacceptable statistic and explained part of the reasons why it’s so high.
“It’s a multi-factorial problem that we see with that discrepancy of care, starting anywhere from implicit bias in the healthcare system to the individual systems to maternal care,” she said. “Sometimes racial disparities in healthcare are access to care, feeling comfortable communicating with your provider, trusting the provider, being able to have access to health insurance, you know, having a system that you feel supported that your voice can be heard.”
Russell said it’s important for care to continue for women after the baby is born.
“In the general population, a leading cause of prenatal mortality is actually mood disorders things like postpartum depression and so on, but in the African-American community it’s cardiac and coronary disease, and so I think we need to shift our direction for how we’re approaching prenatal and post-postpartum care,” Dr. Russell said.
She said it’s important for healthcare providers to understand implicit bias plays a role, and she encourages women of color to find a different provider if they feel like they aren’t being heard.
“Most of the postpartum mortality related to pregnancy happens between seven days to one year postpartum, and so I think keeping women on our radar during their pregnancy is really easy. We’re seeing them all the time, seeing them for all of their regular visits, so in our practice we have really made it a point to see women early after their delivery, and then continue to see them through that fourth trimester for that year following their birth,” Russell said.
That’s why she said Christ Hospital does different screening tests for cardiac risk factors and mood disorders. She said they are also checking in earlier with women after the give birth, and continuing care for up to a year after they give birth.
“We’re hoping to not let women fall through the cracks,” Dr. Russell said. “I think it’s really important for the care not to just fall off after the baby has been born.”
Walters is sharing her story in hopes it will encourage other women to speak and seek help when they feel like something isn’t right.
“As a woman, and a woman of color we have to advocate for our health,” Walters said. “I’m very, very lucky.”
“I think the most important thing for all women is to not be afraid to ask questions,” Russell said.
Russell said it’s important for women of color to advocate for themselves in the prenatal and postnatal period. She said bringing someone with you to your appointment can help and never be afraid to ask questions.
