Giving Birth Almost Killed Me. Pregnancy Shouldn’t Be So Dangerous.

According to Mukherjee, attacks on USAID programs not directly related to maternal mortality, notably family planning and contraception, will also make complications like PPH more deadly. Having children too close together, for example, worsens anemia, which in turn greatly raises a woman’s risk of dying from heavy bleeding. The Guttmacher Institute estimates that the Trump administration’s decision to end financial support for family planning in developing countries will lead to an additional 8,340 deaths from complications during pregnancy and childbirth annually. Similarly, the end of US support for global vaccination programs, including for anti-malaria drugs, will also adversely affect PPH outcomes: Malaria fuels anemia, heightening the danger of blood loss. “It creates a huge vicious cycle of more suffering and death,” Mukherjee said.

Even in advanced economies, where PPH causes 8 percent of maternal deaths, treatment can be hard to come by. In France, where I live, medical deserts are expanding, and the country’s laudable public hospital system is buckling under sustained budget cuts. In the United States, where I grew up, the Trump administration’s assault on National Institutes of Health funding has targeted maternal health research, including projects focused on PPH; in early April, much of the department devoted to improving maternal health at the Centers for Disease Control was put on leave. Meanwhile, the freeze on Title X funding has imperiled women’s clinics, often in states where anti-abortion laws have already strangled women’s healthcare access, including for miscarriages and pregnancy complications. Proposed cuts to Medicaid would devastate maternal healthcare, leaving pregnant women with significant coverage gaps. Thirty-five percent of US counties are considered “maternity care deserts,” meaning they lack a single birthing facility or obstetric clinician, and medical deserts abound.

In much of the world, race can determine whether a woman experiencing pregnancy complications will live or die. In 2023, Black women in the United States died at a rate nearly 3.5 times higher than white women around the time of childbirth, and racial disparities in maternal mortality are similar across Europe and the Americas. Black women worldwide are both more likely to experience pregnancy complications, and, in the United States, are less likely to receive medical interventions to treat them—a disparity that makes them twice as likely to die from PPH than white women.

“When we talk about race in healthcare, we are talking about systemic racism,” Dr. Raegan McDonald-Mosley, the CEO of Power to Decide and a practicing ob-gyn, told me in an interview. “Black women are not more biologically predisposed to hemorrhage, but even in higher-resourced settings are more likely to encounter delays in treatment.” Black women are overrepresented in areas of the United States with medical deserts and states affected by abortion bans—where women are twice as likely to die during pregnancy. “When we layer on the physical lack of access and the fact that providers don’t always treat [Black women’s] symptoms as aggressively, it leads to the intersection of racism and an absence of quality care that can intensify health complications,” she said.

I live in Paris with my pick of hospitals nearby, in a country with an advanced and accessible healthcare system. I am white. I have insurance, paid leave, and a partner and parents who were able to take care of our baby while I was plunged into a hellish ordeal. I was also, in medical terms, extremely unlucky: I was ultimately diagnosed with a rare condition that, according to every medical journal article I’ve been able to get my hands on, has around 100 recorded cases. When my complications persisted even after treatment, doctors told me I was a statistical anomaly.

But I had everything else working in my favor: everything related not to my health but to the privileged accident of my birth. And even with all that, doctors consistently shrugged me off; my daughter could have celebrated her first birthday without a mother.

Still bleeding, I made it back to the clinic. A different doctor was on duty, and she took me seriously. An ultrasound showed retained placenta, and she rushed me into the operating room for a dilation and curettage, a procedure during which the cervix is dilated to empty the uterus—and that, since the reversal of Roe v. Wade, has become unavailable to women facing life-threatening emergencies across swaths of the United States. In Georgia and Texas, for example, a doctor performing the procedure can face jail time, and numerous women have died from blood loss or septic shock after being denied prompt care for complications stemming from retained “products of conception” following abortion or miscarriage.

I was discharged the next morning and eagerly went home to my newborn. Two days later, though, I started hemorrhaging again. Soon I was in an ambulance heading to a full-service hospital, where an MRI confirmed the doctors’ suspicion: I had a uterine arteriovenous malformation, or AVM—an abnormal connection between arteries and veins that can cause intractable, fatal bleeding—and needed more surgery.

I was anesthetized but awake for the procedure, a uterine artery embolization to target the abnormal blood vessels and hopefully stop the bleeding. I watched, rapt, as a team of interventional radiologists worked, the procedure projected on a screen. My fascination was interrupted when the epidural wore off without about 10 minutes of surgery to go, sending excruciating, labor-like pains through my pelvis.

I spent six days at the hospital, most of them in pain. I pumped breast milk every two hours because the doctors, as if reading from a textbook, encouraged me to “maintain my supply,” but by then I hardly had any milk anyway. I watched it collect, not even an ounce per session, and thought about my two-week-old, without me, on the other side of town.

Did my baby know who I was? I googled “what happens when infants are separated from their mothers.” I googled “arteriovenous malformation” and read about how rare it was, how the majority of patients had medical histories that bore no resemblance to mine. It didn’t make sense, so I read the articles again and again, as if the truth would reveal itself in repetition. I googled “postpartum hemorrhage,” and thought about what would’ve happened if I hadn’t gotten to a hospital in 10 minutes or if the hospital had turned me away.

Forty-eight hours after I was discharged, I woke up to a sensation that had become familiar. But another doctor dismissed me: The bleeding, she said, probably resulted from over-exertion. Don’t forget to relax, she told me as I pulled up my leggings.

That afternoon, back for a routine check-up at the clinic where I gave birth, I started shivering violently. My temperature was 104; I was careening toward sepsis. Soon I began bleeding heavily. Doctors rushed in; one reached his gloved hand inside of me and pulled out apple-sized clots. I looked away. My body no longer felt like mine—it was a villain, sinister and volatile and determined to betray me.

I spent another week at the hospital, where I received multiple rounds of IV antibiotics and a blood transfusion. There, the pain got worse. Pain like knives, twisting and digging and roaring across my stomach, back, and thighs. Pain the doctors promised would fade, but instead it stitched itself into my body’s tapestry—one thread in a web of lingering complications that continue to haunt me.

During those hospital stays, people—my parents, my sister, the nurses—kept saying: Think about what’s waiting at home, a perfect baby. So I tried to pull up a photo of her in my mind—her big wet eyes like deep black wells, her tiny body, the thin layer of reddish fuzz covering her head—but that was all I could find: pictures, not memories. Pictures on my phone. I looked at them constantly. They seemed fake, like photos of a doll, or someone else’s baby. I tried to imagine her warmth, her little limbs resting on mine, but it was impossible. I was grasping for foggy snapshots. I wondered: Had she ever even been in my arms? Yes, said the pictures. But it’s hard to replicate the feeling of something you’ve barely experienced, to recall the sensation of holding a baby you’ve barely held.

I did get to hold my baby, eventually. I got to watch her lick the frosting off her first birthday cake and take her first steps. But if the war on maternal health continues apace, the same won’t be true for many other women: those living in states where the law has been twisted against them or in countries where aid has been slashed by a US administration that considers women’s bodies a vessel for reproduction but their livelihoods a flimsy afterthought.

For Mukherjee, what’s required—beyond sustained, robust funding and political will to reduce maternal deaths—is a global social movement. “The arc is very long,” she said. “We need to keep pushing, and we need to be strategic, at a time where our ability to be vocal is somewhat impaired by this climate that is so misogynist, so racist, and so nationalist.” She drew parallels to the international coalition-building that helped drive the response to the AIDS crisis. “If every woman said, ‘We are not going to let our sisters die of hemorrhage,’ if we could generate a women’s movement that puts dignity at the center of all this, there would be power in that.”