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HOUSTON — Tonjanic Hill was overjoyed in 2017 when she learned she was 14 weeks pregnant. Despite a history of uterine fibroids, she never lost faith that she would someday have a child.
But, just five weeks after confirming her pregnancy, and the day after a gender-reveal party where she announced she was having a girl, she seemed unable to stop urinating. She didn’t realize her amniotic fluid was leaking. Then came the excruciating pain.
“I ended up going to the emergency room,” said Hill, now 35. “That’s where I had the most traumatic, horrible experience ever.”
An ultrasound showed she had lost 90% of her amniotic fluid. Yet, over the angry protestations of her nurse, Hill said, the attending doctor insisted Hill be discharged and see her own OB-GYN the next day. The doctor brushed off her concerns, she said. The next morning, her OB-GYN’s office rushed her back to the hospital. But she lost her baby, Tabitha Winnie Denkins.
“This is a public health crisis as it relates to Black moms and babies that is completely preventable,” said Barbie Robinson, who took over as executive director of Harris County Public Health in March 2021. “When you look at the breakdown demographically — who’s disproportionately impacted by the lack of access — we have a situation where we can expect these horrible outcomes.”
In fact, Harris County ranks third, behind only Chicago’s Cook County and Detroit’s Wayne County, in what are known as excess Black infant deaths, according to the federal Health Resources and Services Administration. Those three counties, which also are among the nation’s most populated counties, account for 7% of all Black births in the country and 9% of excess Black infant deaths, said Ashley Hirai, a senior scientist at HRSA. That means the counties have the largest number of Black births but also more deaths that would not occur if Black babies had the same chance of reaching their 1st birthdays as white infants.
No known genetic reasons exist for Black infants to die at higher rates than white infants. Such deaths are often called “deaths of disparity” because they are likely attributable to systemic racial disparities. Regardless of economic status or educational attainment, the stress from experiencing persistent systemic racism leads to adverse health consequences for Black women and their babies, according to a study published in the journal Women’s Health Issues.
These miscarriages and deaths can occur even in communities that otherwise appear to have vast health resources. In Harris County, for example, home to two public hospitals and the Texas Medical Center — the largest medical complex in the world, with more than 54 medical-related institutions and 21 hospitals — mortality rates were 11.1 per 1,000 births for Black infants from 2014 through 2019, according to the March of Dimes, compared with 4.7 for white infants.
The abundance of providers in Harris County hasn’t reassured pregnant Black patients that they can find care that is timely, appropriate or culturally competent — care that acknowledges a person’s heritage, beliefs and values during treatment.
Regardless of income or insurance status, studies show, medical providers often dismiss Black women’s questions and concerns, minimize their physical complaints and fail to offer appropriate care. By contrast, a study of 1.8 million hospital births spanning 23 years in Florida found that the gap in mortality rates between Black and white newborns was halved for Black babies when Black physicians cared for them.
In 2013, Houstonian Kay Matthews was running a successful catering business when she lost the daughter she’d named Troya eight months and three weeks into pregnancy.
Matthews hadn’t felt well — she’d been sluggish and tired — for several days, but her doctor told her not to worry. Not long afterward, she woke up realizing something was terribly wrong. She passed out after calling 911. When she woke up, she was in the emergency room.
None of the medical staffers would talk to her, she said. She had no idea what was happening, no one was answering her questions, and she started having a panic attack.
“It kind of felt like I was watching myself lose everything,” she recalled. She said the nurse seemed annoyed with her questions and demeanor and gave her a sedative. “When I woke up, I did not have a baby.”
Matthews recalled one staffer insinuating that she and her partner couldn’t afford to pay the bill, even though she was a financially stable business owner, and he had a well-paying job as a truck driver.
She said hospital staffers showed minimal compassion after she lost Troya. They seemed to dismiss her grief, she said. It was the first time she could remember feeling as if she was treated callously because she is Black.
“There was no respect at all, like zero respect or compassion,” said Matthews, who has since founded the Shades of Blue Project, a Houston nonprofit focused on improving maternal mental health, primarily for Black patients.
To help combat these high mortality rates in Harris County, Robinson created a maternal child and health office and launched a home-visit pilot program to connect prenatal and postpartum patients with resources such as housing assistance, medical care and social services. Limited access to healthy food and recreational activities are barriers to healthy pregnancy outcomes. Studies have also shown a connection between evictions and infant mortality.
For Hill, not having insurance was also likely a factor. While pregnant, Hill said, she had had just a single visit at a community health center before her miscarriage. She was working multiple jobs as a college student and did not have employer-provided medical coverage. She was not yet approved for Medicaid, the state-federal program for people with low incomes or disabilities.
Texas has the nation’s highest uninsured rate, with nearly 5 million Texans — or 20% of those younger than 65 — lacking coverage, said Anne Dunkelberg, a senior fellow with Every Texan, a nonprofit research and advocacy institute focused on equity in public policy. While non-Hispanic Black Texans have a slightly better rate — 17% — than that overall state level, it’s still higher than the 12% rate for non-Hispanic white Texans, according to census data. Health experts fear that many more people are losing insurance coverage as COVID-19 pandemic protections end for Medicaid.
Without full coverage, those who are pregnant may avoid seeking care, meaning they skip being seen in the critical first trimester, said Fatimah Lalani, medical director at Houston’s Hope Clinic.
Texas had the lowest percentage of mothers receiving early prenatal care in the nation in 2020, according to the state’s 2021 Healthy Texas Mothers and Babies Databook, and non-Hispanic Black moms and babies were less likely to receive first-trimester care than other racial and ethnic groups. Babies born without prenatal care were three times as likely to have a low birth weight and five times as likely to die as those whose mothers had care.
Hill’s twins, though premature, are now preschoolers. “I believe God — and the high-risk doctor — saved my twins,” she says.(Brandon Thibodeaux/KFF Health News)
If Hill’s miscarriage reflects how the system failed her, the birth of her twins two years later demonstrates how appropriate support has the potential to change outcomes.
With Medicaid coverage from the beginning of her second pregnancy, Hill saw a high-risk pregnancy specialist. Diagnosed early with what’s called an incompetent cervix, Hill was consistently seen, monitored and treated. She also was put on bed rest for her entire pregnancy.
She had an emergency cesarean section at 34 weeks, and both babies spent two weeks in neonatal intensive care. Today, her premature twins are 3 years old.
“I believe God — and the high-risk doctor — saved my twins,” she said.
This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF. It has been published with permission.
。    Focus Entertainment Publishing与Afterburner Studios正式公布 《Elta: Defy All Gods(艾尔塔:逆神)》,游戏将于2027年初登陆PC(Steam)、PlayStation 5及Xbox Series X|S。    视频欣赏:在这款紧张刺激的动作平台游戏中,玩家将与自己的龙神伙伴并肩作战,在腐化世界中杀出一条血路,无论前方等待着怎样的敌人或挑战,都无法阻挡你的脚步。准备踏上成为神圣勇士的征途! 游戏试玩版将于10月1日在所有平台免费开放,届时玩家可以抢先体验游戏内容。

二 | 准备迎战众神,为了Elta而战《Elta: Defy All Gods》是一款科幻奇幻风格的动作平台游戏,将自由战斗、流畅的平台跳跃与科幻探索融为一体。

三 | 玩家将扮演 Victus,一名寻找失落之神Elta的精英武僧,希望借此为自己的文明找到继续前行的道路。

四 | 恢复Elta昔日的力量,或许正是开启全新光明未来的关键。随着一次次挑战,Victus与Elta将不断变强,解锁全新的武术技巧与毁灭性魔法能力。

五 | 他们探索的每一个腐化世界都广阔无垠,隐藏着众多秘密。玩家需要不断掌握和运用不断进化的移动能力,才能抵达最遥远的区域。想要成为真正的神圣勇士,就必须同时掌握爆发式战斗与敏捷的平台跳跃。    Afterburner Studios为动作平台游戏带来全新体验由《层层梦境》的独立开发团队打造,《Elta: Defy All Gods》从格斗游戏与3D银河恶魔城游戏中汲取灵感,力求为动作平台游戏类型开辟全新的空间,带来一场以玩法为核心、节奏紧张刺激的全新体验。

六 |     “作为我们的第二款作品,我们的目标更加宏大。

七 | 我们将此前在厚重战斗、出色操作手感以及流畅动作方面积累的经验提升到了全新的高度。

八 | ” Afterburner Studios联合创始人兼游戏总监Ian Cofino表示:“Focus Entertainment一直是我们实现打造世界级动作游戏这一目标的出色合作伙伴,让我们的团队能够将这一极具野心的愿景付诸实践。”     《Elta: Defy All Gods》计划于2027年初发售,登陆PC(Steam)、Xbox Series X|S及PlayStation 5。为了让所有玩家都能体验《Elta: Defy All Gods》区别于其他动作平台游戏的独特魅力,游戏免费试玩版将于10月1日登陆所有平台,其中还将包含游戏开篇内容。立即加入愿望单,并关注Focus Entertainment官方频道,获取游戏最新消息!     关于《Elta: Defy All Gods》与龙神伙伴并肩,在腐化世界中杀出一条血路。这款肾上腺素飙升的动作平台游戏融合了自由战斗、流畅的平台跳跃与科幻探索。成为失落之神Elta的勇者。·展现你的战斗实力: 在激烈的近战中融合致命武术与毁灭性魔法攻击,在敌群中展开爆发式战斗。·探索三大科幻奇幻世界: 穿行于三个蜿蜒曲折的腐化世界,灵活组合各种移动能力,抵达全新区域并发现隐藏其中的秘密。·与Elta并肩磨炼技艺: 不断提升自己的实力,追随祖先的脚步,解锁全新的战斗招式与杂技动作。·击败众神: 推翻那些曾伤害你族人、让他们遭受数百年流放的众神,并帮助Elta纠正这一切,为更加光明的未来铺平道路。本文由游民星空制作发布,未经允许禁止转载。

九 | 更多相关资讯请关注:艾尔塔:逆神专区。

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