A harrowing journey through Houston’s health care system offers an inside look at why so many women are dying after giving birth.
Texas Monthly | By Ricardo Nuila
Editor’s Note: Four days after this story went to press, the medical journal Obstetrics & Gynecology released a report confirming, as this story suggested, that problems with computerized death certificates were at least partly responsible for the reported jump in maternal mortality rates in Texas.
A little after dark, Ebonie Chandler finally had a chance to relax. She had spent the past three days trying to enroll her five-year-old daughter, Blessn, in school, only to get the runaround. It was May 20, 2017, and Ebonie and her two youngest children had been living in Houston for a month. Ebonie had lived her entire life in southern California, but when the rent on her Long Beach apartment became too expensive, she moved with Blessn and her two-year-old son, Lyse, across the country. For now, she was living at her sister Sharonna’s home, in southwest Houston, having left her two older children back in the Los Angeles area with her mother. Ebonie spent this particular day picking up after Blessn and Lyse, making them waffles, keeping them entertained with different renditions of the alphabet song. Now that it was almost Blessn’s bedtime, the two lay in Ebonie’s bed, listening to R. Kelly on Pandora.
Ebonie was exhausted, not to mention a little nauseated, because on top of all she was dealing with, she was also nineteen weeks pregnant. Two of her previous six pregnancies had ended in a miscarriage, and Ebonie was worried she might be having another. Soon before she moved to Houston, she had started experiencing bleeding, especially when she sat down. In recent days, the blood had started to soak through the pads she was wearing, and through her clothes. Sharonna had taken her to the closest emergency room three times in the past month. At the most recent visit, a week earlier, doctors had kept her in the hospital overnight to give her a blood transfusion. Beyond recommending that she find an obstetrician, which she had not yet managed to do, they did little to ensure that Ebonie would receive good care going forward.
As she lay in bed, listening to music after another tiring day, Ebonie suddenly felt something wet beneath her. She made her way to the bathroom, and Blessn followed. When she reached to turn on the light, a cramp hit her right side, and she watched in alarm as the blood collected beneath her, pooling on the floor, much of it mixed with clots. Blessn looked at the blood and then at her mother. “Tell your auntie,” Ebonie instructed her.
Sharonna called 911. An ambulance arrived quickly, and when the driver loaded Ebonie into the back, he asked if she had health insurance. This was something she was familiar with from her recent hospital visits—in California, she was covered by Medi-Cal, the state’s version of Medicaid. But did that cover her in Texas? No one she had talked to during her ER visits had given her clear information, so she didn’t have a good answer for the ambulance driver. As is often the case in such situations, the driver decided to take Ebonie to Ben Taub Hospital, Houston’s largest medical facility that focuses on treating the uninsured.
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