Thanks to tireless activism across the nation, the mortality rate gap for Black and white birthing people has finally garnered enough attention to be thoroughly studied. Although social determinants of health are also an obvious factor in this disparity, racial biases and explicit racism on the part of clinicians is now a well-documented element of this gap. Despite the fact that this research is now readily available, the gap remains a problem, prompting people like Wanda Irving to take action.
Irving, MPA is a co-founder of Dr. Shalon’s Maternal Action Project (DSMAP) and was the keynote speaker at a session of the Maternal Health Alliance’s recent conference. There, she was introduced by Captain Mehran Massoudi, a regional health administrator at the Office of the Assistant Secretary for Health Region 6. “The Action Plan is a community-driven nonprofit organization dedicated to alleviating Black maternal health disparities. The organization was established to honor Wanda’s daughter, Dr. Shalon, who passed away from preventable pregnancy complications in January 2017, three weeks after giving birth to her only child.
Dr. Shalon was a brilliant researcher and fierce health equity champion. In an effort to continue Dr. Shalon’s legacy, Wanda co-founded the maternal action project, where she also serves as president of the board of directors and acting president of the organization. Wanda possesses years of experience in organizational development and community outreach and has led strategic initiatives and programs. Wanda is now fully dedicated to this mission of the Maternal Action Project and utilizes her keen expertise to enhance organizational resources such as Believe Her, an anonymous peer support app aimed to increase awareness of the Black maternal health crisis and promote evidence-based strategies that improve health outcomes for Black women and families.
Her work is based on the mantra of Dr. Shalon Irving: ‘I see inequity wherever it exists. I’m not afraid to call it by name and work hard to eliminate it. I vow to create a better Earth.’ At the Maternal Action Project, we honor Dr. Shalon’s vow by working to remove barriers, biases, and disparate practices that impede access to equitable quality care for Black women and pregnant women.”
Wanda Irving took the stage to tell her daughter’s story.
“Shalon was a dynamic force. She made significant contributions in the field of public health and fought hard to combat health inequities. In honor of her legacy, Dr. Shalon’s Maternal Action Project was created in 2020.
My objective in sharing my story is simply to put a face to the grim mortality statistics so that you can better understand the fierce urgency of now, a term you will hear me repeat several times, and to compel action by policy makers, medical care providers, and communities. Women have been dying for decades at alarming rates, and the rates keep rising. Mental health issues among women are escalating. Communities are losing valuable talent. Society is suffering. Children like Soleil are being left motherless and traumatized. My little granddaughter will never be held in her mommy’s arms, or feel the radiating love from that embrace. The loud absence of her mother in her life seems to be increasing as she gets older and faces the magnitude of her loss. To tackle this crisis, it is imperative that we attack the source and not the symptoms. We must take off blinders and see how racism has and continues to impact health outcomes. Agencies like HHS and HRSA must value the input of those most affected and impacted, and include us in crafting solutions if we are to eliminate systemic racism.
At this point in my life, what I always say is, ‘I am forever the mother of Dr. Shalon Irving.’ That’s how I like to introduce myself. Prior to 2017, if you had told me that 700-900 women die each year as a result of childbirth complications, I would have thought you were talking about rates in a third-world country. If you would have told me that at the age of 70 I would be raising a six-year-old, running a nonprofit organization, and traveling around the country advocating for Black maternal health equity, I would have laughed you out of the room.
If you would have told me that my Shalon, a public health expert, was going to lose her life due to the same public health issues she fought so hard to eliminate, I definitely would have thought you should be fitted for a straightjacket and committed. From the day she was born, I believed Shalon would make a lasting impact on the world, as she’s still doing now. Sadly, Shalon’s fierce urgency to be believed was ignored, suppressed, and disregarded.
Shalon was my only daughter, born between two brothers that she adored. She was an exceptional child. She loved to learn and apply that learning to life. She was fearless, generous, kind, and always remained very, very humble. Shalon lived her truth each and every day. She never lost sight of who she was, nor sacrificed her values and morals under any circumstances. When her expertise was needed, Shalon never failed to answer the call. She was funny, her smile was luminous, and her melodic laughter touched your heart. Shalon was readily accepting of everyone she met and fiercely loyal to her friends, who would all agree that Shalon had a way of making your day brighter and your load seem suddenly lighter. I personally knew that to be true, because from the age of 25, Shalon was my best friend. She was strong, vibrant, beautiful, a woman who wanted a child more than anything.
She had put in the work and was perfectly positioned and prepared when she unexpectedly got pregnant at age 35. Even though we joked about her geriatric pregnancy, what wasn’t funny was that she was among the country’s most vulnerable population. I never thought for a moment that as a Black woman, my daughter was three to four times more likely to die from birth related complications than a white woman, largely attributed to institutional racism and the intersectionality of issues impacting Black lives. Throughout her pregnancy, Shalon did everything right, and on January 3, 2017, in a planned C-section, she gave birth to a beautiful baby girl she named Soleil. According to Shalon, her Sonny was the sunshine of her life, her greatest achievement. However, that euphoria was short-lived.
The weeks that followed Shalon’s birth should have been filled with joy, happiness, and improving health. Instead, she experienced complications starting within three days after the birth of her daughter. She knew something was wrong and tried repeatedly to get her high-risk doctors to take her complications seriously. Instead, her health steadily declined and her blood pressure rose. Shalon vigorously advocated for herself, but her concerns were not adequately addressed by her medical team. She suffered a cardiac arrest at her home on the night of January 24, 2017, just 21 days after the birth of her daughter and a few short hours after returning home from yet another visit to medical providers.
She never regained consciousness and was declared brain-dead on January 26. In accordance with her medical directive, which had a hand-written note at the bottom that said ‘Mommy, if anything happens, know that I will fight hard, but if there is no hope, please let me go,’ life support was removed on January 28, 2017, and my baby girl was gone 14 minutes later.
Shalon was among the 85% of recorded preventable maternal deaths in 2017. Over 30% of those deaths were Black women, even though the Black population in the U.S. is 14%. Shalon, like hundreds of Black women each year, went to her health care workers again and again in distress and was dismissed each and every time.
Her concerns and symptoms went unheard, unaddressed, and untreated. Shalon’s preventable death made me acutely aware of the rampant health disparities in the health care system because she defied the conventional wisdom of who was falling victim to maternal deaths in this country. The purposeful narrative then was that these mothers were uneducated, unemployed, uninsured, and living in poverty.
Shalon certainly did not fit that narrative. She had earned two master’s degrees, a dual-title Ph.D. in sociology and gerontology, the first student to do so at Purdue University, also a cum laude, and was a sociology professor at Hofstra University by age 25. She was in great physical shape and ran 5ks twice a year. Her master’s of public health also summa cum laude, placed her on an impressive path to being a lieutenant commander in the U.S. Public Health Service Commissioned Corps and a well-respected epidemiologist at the Centers for Disease Control.
Shalon’s death in 2017 spotlighted the racism and not race is the key cause of disparities in maternal outcomes and socioeconomic status doesn’t protect a Black pregnant person from becoming a mortality or morbidity statistic in America. In fact, a Black woman with a college education is nearly twice as likely to die of a pregnancy-related cause as a white woman with a high school education. I initially thought the medical system had failed Shalon, but what I came to realize is that it operated exactly as it was set up to operate.
Black women were never part of the American ideal of motherhood which warranted protection and care. Thanks to infamous medical pioneers like J. Marion Sims, Black women’s bodies have been under attack from the time of slavery onward. Doctors, despite their oath to do no harm, have been active players in the assault. As Dorothy Roberts’ book, 1997 Killing of the Black Body reveals, America’s use of Black women’s bodies has been systemic, leading to the degradation of Black motherhood and the exclusion of Black women’s reproductive needs in mainstream feminist and civil rights agendas. The fierce urgency of now demands we address the racism if we want to stop the continual widening of the equity gap and the incessant increase of health disparities.”
The atrocities of the past led to the tragedies of the present, and Black birthing people deserve to give birth in a health care system that has their backs.
To learn more about the DSMAP, visit https://www.drshalonsmap.org/.