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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.
。 "외교자원으로 조금이라도 관계 안정 꾀할 것" [경주=AP/뉴시스] 가나스기 겐지(金杉憲治) 주중 일본 대사는 악화된 중일 관계가 11월 중국에서 열리는 아시아태평양경제협력체(APEC) 정상회의를 계기로 개선될 수 있겠느냐는 질문에 "솔직하게 말하자면, 낙관할 수 있는 상황이 아니다"라고 밝혔다. 사진은 시진핑(오른쪽) 중국 국가주석과 다카이치 사나에 일본 총리가 지난해 10월 31일 경주에서 아시아태평양경제협력체(APEC) 정상회의를 계기로 열린 정상회담에 앞서 악수하고 있는 모습. 2026.08.26.[서울=뉴시스] 김예진 기자 = 가나스기 겐지(金杉憲治) 주중 일본 대사는 악화된 중일 관계가 11월 중국에서 열리는 아시아태평양경제협력체(APEC)를 정상회의 계기로 개선될 수 있겠느냐는 질문에 "솔직하게 말하자면, 낙관할 수 있는 상황이 아니다"라고 밝혔다. 가나스기 대사는 지난 25일자 TV아사히방송과의 인터뷰에서 이같이 말했다. 이어 "다만 모처럼 그런 기회가 주어진 만큼, 우리는 이를 위해 외교 자원을 사용해 조금이라도 중일 관계가 안정될 수 있도록 하고자 한다"고 강조했다. 가나스기 대사의 이번 발언은 양국 관계 경색이 장기화하는 가운데, 오는 11월 APEC 회의를 계기로 양국 정상 간 접촉 여부가 주목되는 상황에서 나왔다.올해 APEC 의장국은 중국으로, 시진핑(習近平) 중국 국가주석이 참석할 전망이다. 다카이치 사나에(高市早苗) 총리도 참석할 것으로 점쳐지고 있다. 중일 관계는 지난해 11월 다카이치 총리가 국회에서 대만 유사시 개입 가능성을 언급하면서 급속도로 악화됐다. 다카이치 총리는 지난달 27일 기자회견에서 APEC 정상회의를 "기대하고 있다"고 밝힌 바 있다. "중국은 중요한 이웃나라"라며 "중일 간 우려와 과제가 있기 때문에 모든 수준에서 다양한 기회에 대화를 하고 의사소통을 하는 게 중요하다"고 언급했다. 그러나 가나스기 대사는 인터뷰에서 "지난해 11월 이후 나를 포함한 대사관 직원은 중국 정부 관계자, 학계, 중국 비즈니스맨을 만나는 것이 매우 어려워졌다"고 토로했다. 그는 "원래라면 어려운 시기일수록 대화를 하는 것이 바람직하며, 그것을 중국에게도 요구하고 있으나, 유감스럽게도 현재로서는 의미있는 대화를 중국과 나누고 있지 못하고 있다"고 말했다. 가나스기 대사는 방일하는 중국 방문객의 사례를 들며 “일본의 소프트파워에 자신을 가지고 확실하게 계속 호소해 나가는 것이 필요하다”고 말했다. 그는 "미국도 지금 이 순간만 놓고 말하면 중일 관계가 좀 더 안정돼 있는 편이 좋다고 생각하고 있다"며 중일 간 대화, 교류가 차분히 진행되길 바란다고 했다.。Current article:http://6un.ganweilingmukuai.shop/2esnnu/9tvgj57.html
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