Report on Maternal Health Risks and Patient Advocacy in the Context of Sustainable Development Goals

This report examines the critical issues of postpartum complications and patient advocacy, using the widely publicized experience of Serena Williams as a case study. The findings underscore the urgent need for progress toward United Nations Sustainable Development Goal 3 (Good Health and Well-being), particularly Target 3.1, which aims to reduce the global maternal mortality ratio.

Case Study: Serena Williams’ Postpartum Complications

Incident Overview and Link to SDG 3

Following the birth of her daughter via an emergency Caesarean section, Serena Williams experienced life-threatening complications, specifically a pulmonary embolism (PE). This event highlights the severe risks associated with childbirth and the critical importance of high-quality post-natal care, a cornerstone of achieving SDG 3. A PE is a blockage in a lung artery, a condition that is a leading contributor to maternal mortality worldwide.

Patient Advocacy and Systemic Barriers to Care

A significant aspect of this case is the patient’s struggle to have her health concerns recognized by medical professionals. Ms. Williams reported having to advocate persistently for herself before receiving the necessary diagnostic tests and treatment. This experience reveals systemic challenges within healthcare that can prevent equitable and timely care, directly impacting the objectives of SDG 3.8 (Achieve universal health coverage, including access to quality essential health-care services). Furthermore, the dismissal of a woman’s testimony about her own body is a critical issue related to SDG 5 (Gender Equality).

• The patient knew something was wrong post-delivery but had to “fight to be believed.”
• This struggle for validation underscores the importance of patient-centered care and listening to women’s health concerns.
• Ms. Williams has since emphasized the importance of self-advocacy, stating, “Your body is always talking to you. Listen to it. Trust it.”

Pulmonary Embolism: A Major Factor in Maternal Mortality

Clinical Profile and Global Health Impact

Pulmonary embolism is a primary cause of maternal death, accounting for a significant percentage of postpartum fatalities. In the United States, PE is responsible for approximately 5.7% of all maternal deaths. Reducing mortality from preventable conditions like PE is essential to meeting SDG Target 3.1.

Symptoms and Diagnostic Challenges

The diagnosis of PE can be complicated by the overlap of its symptoms with common postpartum and pregnancy experiences. This diagnostic difficulty necessitates heightened vigilance from healthcare providers and robust healthcare systems, as promoted by SDG 3.

Key symptoms include:

• Sudden shortness of breath
• Sharp chest pain
• Coughing, potentially with blood
• Swelling or pain in one leg (indicative of Deep Vein Thrombosis, DVT)

Identified Risk Factors for Pregnancy-Associated Pulmonary Embolism

Contributing Health and Procedural Factors

Several factors increase the risk of developing PE during or after pregnancy. Awareness and management of these risks are fundamental to preventative healthcare and advancing global health outcomes under SDG 3.

1. Obesity: A Body Mass Index (BMI) over 30 significantly increases risk.
2. Medical History: A personal or family history of blood clots or DVT.
3. Pregnancy Type: Multiple-birth pregnancies (e.g., twins).
4. Delivery Method: Caesarean sections are a known risk factor.
5. Co-morbidities: Certain medical conditions, such as irritable bowel syndrome.
6. Genetic Predisposition: Inherited clotting disorders.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

SDG 3: Good Health and Well-being

• The article’s central theme is a serious maternal health complication, pulmonary embolism (PE), which Serena Williams experienced after childbirth. It explicitly states that PE is a “life-threatening condition” and a “leading cause of maternal deaths,” directly aligning with the goal of ensuring healthy lives and promoting well-being for all at all ages, particularly for mothers.

SDG 5: Gender Equality

• The article highlights Serena Williams’ struggle to have her health concerns taken seriously by medical professionals. Her quotes, “I had to fight to be believed” and “I’ve had to fight to be heard, even when I knew something was wrong,” point to a potential gender bias in healthcare where women’s symptoms and self-reported concerns are sometimes dismissed. This connects to the goal of ending discrimination against women and ensuring their full participation and empowerment, including in their own healthcare decisions.

2. What specific targets under those SDGs can be identified based on the article’s content?

SDG 3: Good Health and Well-being

1. Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
   • The article directly addresses this target by focusing on pulmonary embolism, which it identifies as being “responsible for approximately 5.7% of maternal deaths” in the US. Discussing a leading cause of maternal death is intrinsically linked to the effort to reduce it.
2. Target 3.8: Achieve universal health coverage, including… access to quality essential health-care services…
   • Serena Williams’ experience of having to “demand care repeatedly before doctors took her concerns seriously” indicates a gap in the quality of healthcare services. Her struggle suggests that even with access to a facility, the care provided was not immediately responsive or effective, which is a key component of this target.

SDG 5: Gender Equality

1. Target 5.1: End all forms of discrimination against all women and girls everywhere.
   • The article implies a form of discrimination or systemic bias within the healthcare system. Serena’s statement, “I had to fight to be believed,” suggests her concerns were not given the same weight or urgency they might have been, a challenge many women report facing in medical settings. This struggle is a barrier to achieving full gender equality in all aspects of life, including health.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Indicators for SDG 3 Targets

• Indicator for Target 3.1 (Maternal Mortality): The article provides a specific statistic that can be used as an indicator: the percentage of maternal deaths attributed to a specific cause. The text states that in the US, pulmonary embolism is “responsible for approximately 5.7% of maternal deaths.” This data point is a direct measure related to the broader official indicator, 3.1.1: Maternal mortality ratio.
• Indicator for Target 3.8 (Quality Healthcare): The article provides a qualitative indicator. Serena Williams’ personal testimony of having to “fight to be believed” and “demand care repeatedly” serves as an anecdotal measure of the quality of care. While not a formal quantitative indicator, such narratives are crucial for assessing whether healthcare is truly patient-centered and responsive, which are core elements of quality universal health coverage.

Indicator for SDG 5 Target

• Indicator for Target 5.1 (Discrimination): The article implies a qualitative indicator for discrimination. The account of a prominent woman needing to “fight to be heard” by medical professionals serves as powerful evidence of systemic issues. Tracking the prevalence of such experiences through surveys or patient feedback could be a way to measure progress in eliminating gender bias in healthcare. Serena’s story itself is an indicator of an existing problem.

4. Table of SDGs, Targets, and Indicators

Source: timesofindia.indiatimes.com