NYC's high maternal deaths defy usual explanations

RITA HENLEY JENSEN | 5/25/2011, 9:24 a.m.

A very pregnant Akira Eady, 21, lived in New York City in 2007 with her two young children. With a regular job, private health insurance and a partner who was the father of her other two children, she had every right to expect the birth of her third child to go smoothly.

Instead, Eady died shortly after giving birth at Mount Sinai Medical Center, one of New York City's most prestigious hospitals. Her infant lived. The official cause of death of the this African-American mother of three, as recorded by the New York City medical examiner, was heart failure after post-partum seizures.

Eady's aunt, Carole Eady, recounted recently that her niece bled heavily after receiving an epidural to ease the pain of labor. After giving birth, she complained of headaches. Nevertheless, the hospital released her. Two days after giving birth, she had a seizure and then a heart attack. She was brain dead four days after giving birth.

Carole Eady, now raising Akira's oldest daughter in her Harlem home, acknowledges that her niece's partner might have played a role in her death by hitting her on the morning of her seizure, but she feels strongly that the hospital staff did not properly administer the epidural or respond to her complaint of headaches.

Mount Sinai's press officer was unable to comment on Eady's death because of the state's privacy laws.

20 DEATHS IN 2007

Eady was one of the city's 20 African-American new mothers who died in 2007 as a result of a pregnancy gone wrong. With the absolute numbers of African-American births in New York city dropping, the city's vital statistics reports state that African-American women had a maternal mortality ratio of 68.7 (the number of deaths if 100,000 women had given birth) in 2007.

The following year, 22 African-American women died in New York City from "pregnancy-related causes," for a maternal mortality ratio of 78.8.

Dr. Jo Ivey Bufford, president of the New York Academy of Medicine and a researcher in maternal mortality, estimates that 45 percent of these deaths are preventable.

In New York City in 2008, two white women died during pregnancy and childbirth, for a maternal mortality ratio of 5.1. The following year, four white women died for a maternal mortality rate of 10.4, according to the New York City vital statistics reports.

Going beyond the data that is routinely gathered, New York's health department issued a report on maternal mortality for the city in the years 2001 to 2005 that provides an unprecedented level of detail about which women die and how.

The findings drew no conclusions about how to lower the high rate of maternal deaths in New York--among the highest in the nation--and among African-Americans.

But the city's report does detail the high risk of Cesarean sections. The New York study found that a whopping 79 percent of all mothers who died of pregnancy-related causes gave birth via C-section. In addition, other reports from New York City's health department indicate a consistent rise in C-sections in the city, from 25.8 percent of all births in 1997 to 34.4 percent--more than a third--of all births in 2008.