The loss of any mother is a profound tragedy that leaves an indelible mark on those left behind. The heartrending loss of Tori Bowie to eclampsia is yet another instance in the distressingly lengthy chronicle of Black women who have unnecessarily lost their lives during pregnancy.

The particularly distressing circumstances surrounding Kira Dixon Johnson's passing, however, strikes a deep, resonating chord within me. Speaking as a mother, as a black woman, and significantly as a surgeon, the thought of a patient being allowed to bleed out over the span of several hours is unfathomably distressing. Further compounding the anguish is the baffling decision to send an unstable, hemorrhaging patient for a CT scan. I can barely fathom the heart-wrenching dread that Charles Johnson, Kira's husband, must have experienced as he strived—fruitlessly—to secure the necessary help for his wife.

Preventing such horrific scenarios is the core driving force behind the obstetrical emergency pathway we've designed at Diosa Ara. As a Black OB/GYN and the mother of young children, I've observed numerous passionate outcries and expressions of grief, often tainted with an unnerving sensationalism and voyeurism following the demise of Black individuals. Yet, in the absence of actionable steps towards change, these manifestations of sympathy offer little more than a Band-Aid solution to a deep-seated issue.

We need more than words and empathy; we need a tangible shift in the landscape of maternal healthcare.

With this in mind, I suggest we begin with three solid, practicable strategies to convert our words into action. These steps involve (1) conducting thorough investigations into each case of maternal mortality, (2) allocating resources and investing in research aimed at maternal health conditions, and (3) directly confronting and combating the systemic racism ingrained in our healthcare system.

In these challenging times, it's crucial to move past mere discussions and take the necessary steps to ensure no more mothers suffer the fate of Kira Dixon Johnson.

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Thoroughly Investigate Maternal Mortality

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The black maternal death rate and neonatal deaths in America persist at an alarmingly high level, yet they are often treated as within the realm of normalcy. Instead of accepting this as a given, we must recognize it as an epidemic and take action. These tragic events should be rare, and each case warrants thorough investigation with the same rigor and determination usually reserved for fighting deadly diseases. Despite our efforts to examine available information for a deeper understanding of these women's experiences, we've found little detail. Families should have the opportunity to provide as much information as they feel

comfortable, and medical records must be closely examined for signs of systemic racism or racial bias. Leaving these investigations to hospitals or litigation alone is insufficient for addressing this critical issue.

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Invest in Solutions for Maternal Health Conditions

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The prevailing healthcare landscape is riddled with significant inequities, particularly in the realm of maternal health. These disparities are often starkly evident in conditions such as preeclampsia, a potentially dangerous complication that develops during pregnancy. Alarmingly, it disproportionately impacts women of color, further underscoring the urgent need to confront these gaps head-on.

Currently, our preventive treatments for preeclampsia, including aspirin and magnesium, offer limited effectiveness. There is a pressing need to fuel the research engine, develop new treatments, and challenge this status quo, especially when the health and well-being of black women are at stake.

The global healthcare research and innovation investment landscape, however, presents a less than promising picture. A mere 1% of resources are channeled towards female-specific conditions, with the exception of oncology. This is a sobering reality that necessitates a concerted effort to recalibrate our investment priorities.

An inclusive decision-making process is a critical element in crafting solutions that resonate with diverse patient populations. As of 2022, according to the "All In: Female Founders in US VC Ecosystem" report, women constituted only 16.1% of venture capital (VC) decision-makers.

Despite the progress over the years, these figures show that there's a long road ahead. It is imperative that we amplify female voices and perspectives in the venture capital space, ensuring they have a seat at the table to influence critical healthcare investment decisions.

If we delve deeper into the pharmaceutical research investment trends, the stark funding gap becomes all the more visible. As per a 2020 McKinsey report, non-oncology female health conditions secured a meager 1% of pharmaceutical research funding. The scenario is no different in medical technology, where non-cancer related women’s conditions attracted only 2% of funding.

These glaring disparities call for a paradigm shift in how we perceive and invest in women's health, especially maternal health. It's high time we prioritize research and development for conditions like preeclampsia, which disproportionately affect women of color.

By doing so, we can hope to develop more effective preventive treatments and genuinely improve health outcomes for black women. The need of the hour is to channel more funds, fuel more innovation, and foster a healthcare landscape that upholds equity and inclusion at its core.

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Tackle Systemic Racism in Healthcare Directly

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Eliminating racial disparities in maternal health outcomes necessitates directly confronting systemic racism in healthcare. Medical professionals must be forthcoming when discussing race and its impact on health outcomes, rather than avoiding discomfort or reacting defensively. Implementing data-driven, practical interventions at the point of care plays a crucial role, rather than solely focusing on external factors.

To foster meaningful change, we must empower Black women during their healthcare journeys. At Diosa Ara, our unique approach prioritizes using our expertise to manage obstetrical emergencies and develop strategies for addressing deviations from care.

Recognizing that poor maternal outcomes are often driven by racist attitudes experienced during crucial care situations, we focus on providing patients with 24/7 support amid emergency care. By acting as an additional set of eyes and ears for our patients, we intervene when we believe significant care errors have occurred, employing evidence-based medicine and adhering to the latest practice guidelines to uphold the standard of care.

This approach considers the power imbalances Black women might face during healthcare interactions and aims to intervene at the most vital moments.

As a society, our shared responsibility lies in addressing maternal mortality and racial disparities in healthcare. By investigating maternal deaths thoroughly, investing in research for maternal health conditions, and tackling systemic racism in the medical community, we can collectively ensure that no woman has to fear losing her life during childbirth.