Dr. Michelle Owens, a maternal fetal medicine specialist, is currently the National Secretary for the American College of Obstetricians and Gynecologists (ACOG), the president of the Mississippi State Board of Medical Licensure and the clinical director at Mae Health. She has been practicing as an OB-GYN in Mississippi since 2004.
Owens spoke with reporter Pam Dankins following the death of three-time Olympic medalist Tori Bowie, from Sandhill, Mississippi.
In early May, Bowie was found deceased at her Florida home. According to the autopsy report issued by the Orlando medical examiner’s office, the 32-year-old was eight months pregnant, alone at home and undergoing labor at the time of her death. The 2012 University of Southern Mississippi graduate reportedly experienced complications such as respiratory distress and eclampsia, a rare high blood pressure condition linked to seizures.
Kimberly Holland, Bowie’s agent, stated to CBS that Bowie didn’t trust hospitals.
For Black women in Mississippi and across the United States, pregnancies and child births are even more dangerous. In Mississippi, the pregnancy-related mortality ratio had increased from 33.2 to 36.0 deaths per 100,000 live births in the span of three years.
The same report further showed the pregnancy-related mortality rate of 65.1 deaths per 100,000 live births for Black women was more than quadruple the death ratio for white women.
Owens explained in a sit down with Mississippi Today that policymakers, health care providers and communities must address underlying factors – hypertension, mental health, infections, etc. – within maternal health in order to ensure that all women, regardless of race or ethnicity, have access to care and support.
This interview has been edited for clarity and length.
Pam Dankins: What was your reaction to the news of Tori Bowie’s death?
Michelle Owens: Well, I think my response might have been a little different because I have been doing work in this space. For me, I think it was sadness also mixed with a tinge of frustration because Tori wasn’t the first, and this is something that is increasingly more common. When I think about the people who I’ve had the privilege of caring for, who are in many instances, people from underrepresented groups and from marginalized communities, this is way too common in those communities.
It makes you think, ‘What can you do? Who is immune?’ You can be a highly competitive athlete at the top of your game, and this still occurs. Some of the complications of pregnancy are not just set aside for those people who are unhealthy.
The truth is that pregnancy complications, life-threatening pregnancy complications, can also occur in those people who we would think of as being, you know, the epitome of health. And so, it was frustrating and sad because we know that a lot of these deaths could be preventable. Every death is one more too many.
Dankins: What has been done to reduce maternal mortality in the state?
Owens: So in Mississippi, since 2017, we have a maternal mortality review committee (MMRC), and that committee has been charged with the responsibility of reviewing maternal deaths. They take a deeper dive into each of those situations and make recommendations about the issues that we discover that ultimately, will hopefully, help to decrease mortality rates.
Our State Health Officer Dr. Dan Edney has decided to elevate maternal health as one of the priorities during his tenure. He’s tried to help by not only spreading the word but engaging the medical community and community partners by using the State Department of Health as a vehicle. This way the general public can be aware of the risks and how pregnancy complications can influence not only maternal health, but also health across the lifespan of a birthing person.
There are community organizations that are spread across the state, and there are community partners who are working to help raise awareness. For instance, Mom Me is an organization that kind of focuses on maternal mental health services. Six Dimensions is another organization that is really interested in helping to improve outcomes among Black birthing people.
I think through our Perinatal Quality Care Collaborative (a network of teams collaborating with the state Health Department to improve maternal and infant care), the MMRC (maternal mortality review committee) and the assistance of our state health officer, there’s a lot of positive movement in spreading awareness and helping people to understand the problem. The maternal health crisis is not just in Mississippi but in our country. And, the people who tend to know the least about it are the ones who are at the greatest risk and sense of potentially being most affected.
Dankins: How can you spread awareness to people who may have trouble accessing this information?
Owens: Well, I think the most important thing is meeting people where they are. It’s talking to people in where they live, like at churches and at sporting events. I hope that people understand that we can’t take our health for granted. And just because you are quote, healthy or healthier than most, it still doesn’t mean that you can’t have a life-threatening complication, especially when it pertains to pregnancy. I think that we need to be talking about this in our communities, neighborhoods, Facebook groups, group chats with our friends and wherever there are groups of people who care about each other. It needs to be part of the conversation.
Because only through making sure that people have awareness, do we really make significant strides in closing gaps once people have the awareness.
We also have to make sure that the people who are supposed to be listening, are listening and responding. It’s not entirely on the families of these individuals and themselves. There is a substantial portion of that burden that is also carried by the health care community, that when these concerns are raised, that we are doing our due diligence to fully investigate them in order to ensure that people are getting the care that they need and deserve.
Dankins: Why, with all of the resources the United States has, do we rank so poorly in this area in Mississippi specifically?
Owens: The answer to that is multifactorial.
I think we have challenges as a primarily rural state, and we have the challenge of maternal health deserts. There are so many counties within our state where people don’t have ready access to women’s health services. Like obstetrical care, how many places can you deliver? How many hospitals actually perform deliveries? How many places actually have an OB-GYN, a nurse midwife or a family medicine doctor who performs deliveries? Number one, there aren’t a lot of people that are doing this work. Number two, those people tend to be more highly concentrated in more populous areas. And so, our rural areas of the state have specific challenges because there can be broad swaths of land where there’s nobody providing care.
There are, of course, social challenges. I mean, the vestiges of structural racism that exist within our state, and not just our state, but within this part of the country. The socioeconomic divide and issues with people not being able to access affordable health care. Fortunately, most of the people who would fall into that category when they’re pregnant would have access to Medicaid, and thankfully now, will have coverage for up to a year after birth. Those are some of the small wins that hopefully will help to make a difference but there are many challenges.
That’s why it is going to take a concerted effort on all fronts for us to see the change that is needed. Because it’s not like there’s just one main contributor to the problem. There are several small things that we have to really work on. And once we do it right for a while, we have to be consistent and maintain our vigilance as we’re working to optimize maternal health. We can’t do it for a couple of years, see our numbers get better and then go back to the way things were. We have to make sure that the changes that we implement are sustainable, and that they continue to be passed on. We have to spread the things that work from institution to institution and from providers and practices on to other providers and other practices, so that we see this as a sustainable improvement for our state.