A good story starts with an engaging character. Annie Waldman’s “How Hospitals Are Failing Black Mothers,” details the death of mother of seven, Dacheca Fleurimond, at a New York, “black-serving” hospital. Waldman elevates her story by alternating science and emotion, introducing balanced yet comprehensive medical theory, and using dramatic anecdotes to emphasize impact.
Waldman introduces Fleurimond’s story with little science, instead detailing the intricacies of her delivery. Despite successfully birthing at SUNY Downstate five times prior, Fleurimond’s sister urges her toward a better-rated hospital in Brooklyn. The initial tone conveys a sense of doubt, contrasting Fleurimond’s expressed optimism. She is experienced, not only in childbirth but also at this hospital. While delivering, Fleurimond hemorrhages, yet is stabilized and wakes up without issue. However, Waldman dramatically flourishes with, “She wouldn’t survive the [next] day.”
With a drastic tonal shift, Waldman presents a scientific exposition. Waldman conjectures that the risk of childbirth is significantly worse for black mothers at “black-serving” hospitals, or hospitals with a higher proportion of black mothers than the local average. This relationship shows that hemorrhaging—severe bleeding—is linked to significantly worse outcomes than at hospitals serving a lower proportion of black women. Waldman uses data to prove that black mothers have worse outcomes. Additionally, Waldman concludes, that “black-serving” hospitals also parallel these poor outcomes.
SUNY Downstate is one such hospital, “where 90 percent of the women who give birth are black,” that experiences almost twice the number of hemorrhagic complications. SUNY Downstate claims that the “underserved and high-risk” population they care for is to blame. Waldman introduces science that supports this claim, detailing that these characteristics can lead to poor outcomes.
This alternation between scientific explanation and climatic emotion balances Waldman’s narrative. Consequently, Waldman successfully elevates the story by ensuring engagement. Further, Waldman weaves through medical research and theory to clarify the methodology behind the scientific claims.
Hemorrhages are the easiest “control” that researchers can use—complications following hemorrhage direct conclusions. In Waldman’s discussion of the medical science underlying Fleurimond’s death, she underscores the complications Fleurimond faced before delivery. These complications are expressly related to a high risk of harm.
However, Waldman counters with a shocking and empathetic conclusion: poor characteristics, demographics, comorbidities, or lifestyle cannot be an excuse for poor quality of care. Despite Fleurimond being disadvantaged by multiple complications, those characteristics are not to blame. Rather, the quality of care that Fleurimond received was responsible for her death. SUNY Downstate needs to be held accountable.
By providing a comprehensive and balanced analysis of medical scientific theory, Waldman successfully engages the audience and highlights the deficiencies of medical care that Fleurimond received. Additionally, the discussion of science emphasizes the importance of these hospitals to reevaluate their practice.
Dramatic and engaging anecdotes throughout the article parallel the science of Waldman’s story. In discussing Fleurimond’s lengthy visit with her twins just hours before her death, Waldman describes, “They had her round cheeks, which shone like polished apples.” A later parallel of two paragraphs describes her death, “She said she was in pain and asked [the father of the twins] to come to the hospital, then hung up and waited, alone,” and “After more than an hour of resuscitation attempts, she was pronounced dead at 7:45 pm.”
Waldman furthers the narrative of black mothers disadvantaged by obstetric medical care by introducing Tanesia Walker. Fleurimond was at risk of complications due to hemorrhaging. In contrast to Fleurimond, Walker had little to no risk. She represents the half of black women without risk factors who still died in childbirth. Walker arrived at SUNY Downstate as a healthy, young pregnant woman and didn’t leave. Waldman poses Walker as a victim of the system, who despite having low risk factors, delivered at a hospital rid of disparity and died in the process. Thus, Walker serves as an anecdote to prove that even healthy black women are catastrophically impacted.
The disadvantages of a medical system without equity are apparent and appalling. Waldman crafted this narrative by explaining the circumstances of Dacheca Fleurimond’s death. The lack of care provided by SUNY Downstate Hospital underscores the inconsistencies and prejudice black women face at “black-serving” hospitals. The dramatic diction used to describe Fleurimond’s delivery and death engages and persuades the audience – an emotional appeal to young motherhood. Waldman introduces medical science to reconcile complex theories to the tragic effects of a disadvantaged system. This interwoven cloth of substance and matter – science and story – elevates Fleurimond’s story. A black mother’s fate is demonstrative of obstetric health care, Waldman claims, that is ridden with racism and without equitable care.
Science Writings 