Pregnant women should not be left alone - the missing cause of death for Tori Bowie
21 June 2023
Frentorish (Tori) Bowie was an Olympic medal track star who was found dead on 2 May 2023 after a wellness check. An autopsy revealed that she was eight months pregnant and died from complications of childbirth including respiratory distress and eclampsia. She weighed only 96 pounds, which is 32 pounds below her competition weight. Her child appeared to be stillborn.
Preeclampsia is a pregnancy-related condition diagnosed based on the presence of hypertension (high blood pressure), proteinuria (high levels of protein in the urine) and edema (swelling due to excess fluid in tissues, usually in the legs and feet). Preeclampsia affects 5-7% of all pregnant women and causes 70,000 maternal deaths worldwide each year. In the U.S., it is also a leading cause of maternal death (Rana 2019). It may be caused by ischemia (inadequate blood supply) in the placenta and uterus (Jung 2022). Eclampsia is defined as preeclampsia with convulsions.
What does preeclampsia look like in the placenta?
Placentas: normal (left) compared to a shrunken and preeclamptic placenta (right). Image source
Blood clots in cut sections of a preeclamptic placenta. Image source
Microscopic image of blood clot in a placental vessel, associated with preeclampsia. Image source
Thickened placental blood vessel walls associated with preeclampsia. Image source, see also Wikipedia
For Ms. Bowie, I suggest that another cause of her death, besides eclampsia, was an inadequate support system. Every pregnant woman or girl needs someone to check up on them at least 1-2 times/day because pregnancy complications that require immediate attention are common and the patient may be unable to recognize the problem or get the help she needs on her own. In this case, Ms. Bowie’s estimated date of death, per her obituary, was 23 April 2023, which suggests that nobody had any contact with her for at least 9 days. Without assessing blame, that should not have been allowed to happen. If she had regular contact with others, her preeclampsia or eclampsia may have been successfully treated.
Going forward, I suggest that prenatal evaluations should assess the presence or absence of a support system, with a referral to a social worker if necessary, to ensure regular visitation or contact, particularly for those living alone. In addition, friends and family of every pregnant woman or girl should ensure, to the extent possible, that someone is frequently present to provide support and to identify and manage emergencies. This should be done, to the extent possible, even if the pregnant patient prefers to be alone. This will help reduce the rising maternal mortality rates in the US.
Sources: NPR and Centers for Disease Control and Prevention.
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Reading Tori Bowie’s obituary was shocking and sad for the exact reason you pinpointed here. If isolation during pregnancy hadn’t left her so vulnerable, she may have faced birth, nursing, round the clock childcare, postpartum bodily changes and all of that on her own, too. That’s the future for so many American women and girls - no support while they attempt the hardest, most consequential thing they’ve ever had to do. Shame on this country. RIP Tori.