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Olympic medalist Tori Bowie was eight months pregnant when something went wrong, and she died alone, in the middle of giving birth. 

Though her obituary estimates that she died around April 23, Bowie’s body was not found until May 2, when local authorities in Orange County, Florida, performed a welfare check on her. Whereas often the stories and names of those impacted by the maternal mortality crisis go unheard of, Bowie was a three-time Olympic medalist who at one point was deemed the “world’s fastest woman.” News of her death sent ripples across the country, illustrating what Black women advocates have been saying all along — that the country’s maternal health crisis, with its comparatively high rate of death from pregnancy-related complications, impacts Black women disproportionately regardless of income, education level or even previous health status. 

In the wake of her death, advocates continue to call for institutional support for Black women and meaningful policy change to save more lives. 

No one knows exactly what happened during Bowie’s final moments. But Nancy Metayer Bowen, the first Black and Haitian-American woman commissioner in Coral Springs, Florida, and a member of the reproductive justice group Black in Repro, said it is imperative to create systems that will allow Black women to feel like they will be supported by emergency services in their moments of need. 

Bowie was looking forward to a new phase in her life. She told her agent, Kimberly Holland, that she was excited to bring a baby girl into the world. According to her autopsy report, she also lived with bipolar disorder in a society that can be hostile to those living with mental health conditions —especially when they are Black.

“I think this is a true testament of why mental health is super important,” Bowen said. “Not only in mental health, but maternal health as well. We are a lot for a lot of people. We’re mothers, we’re sisters, we’re partners, etc. And that can be a lot for some people, especially when you’re trying to have a career, have a family and do it all.”

Bowen believes it is critical to create a society where Black women can feel safe and that they can trust the institutions that are supposed to serve them. 

“In order for us to assist people, especially Black women, we have to feel that we have institutions that we can rely on and that will not criminalize us,” Bowen said.. “It’s unfortunate that she did not have the support or didn’t have people around her when she passed, but that says a lot about trust in our communities. You can pull all the money and resources, but if the community does not trust the institutions, we’re going to have more and more of these issues occur,” she said.

Black in Repro is a coalition of Black women in Florida who came together because they believe that reproductive health is part of their larger struggle for safety. The group’s leaders say they fight for policy change because their survival depends on it. 

Holland told CBS that Bowie had intended to have a home birth, but that the circumstances of her premature labor and death suggest she was taken unaware. As an Axios report notes, an increasing number of Black women are choosing to give birth at home or in birthing centers in response to the maternal health crisis that is plaguing them. 

But Esther McCant, a Florida doula involved with Black in Repro, noted that recent events — like Bowie’s death or Serena Williams’ postpartum complications — leave some Black women feeling like it is unsafe to give birth anywhere. “You have Black women who are conflicted because they also feel like the hospital isn’t safe. So where can Black women give birth in this country and still feel safe and supported and have every bit of care that is necessary to sustain a healthy pregnancy and safe birth experience?”

Speaking of Bowie in particular, McCant said, “She had some kind of hospital record, which means she touched the hospital system at some point. When those touches happen, we need to be aware that those touches are critical. Every time you’re interacting with a Black woman in the hospital system is going to be critical because it can positively or negatively impact whatever happens once they leave your doors.”

Keisha Bentley-Edwards, an associate professor in medicine at Duke University, said that to understand the maternal mortality rate, it’s critical to understand the role that systemic racism plays in endangering women who are otherwise healthy going into pregnancy. 

“Obviously, we don’t know all the precursors to her death, and unfortunately, she can’t tell us, herself, what she was experiencing during her pregnancy. But what we can say is she was someone who should have had access to high-quality care. You really can’t get any healthier when it comes to physical fitness than an Olympic track athlete,” Bentley-Edwards said. 

She said the period between ages 25-34 is considered the golden age to give birth. It is the age group during which a pregnant person should be able to expect the least amount of complications — and for White women, it is. But as Bentley-Edwards noted, this age group is actually where there is a bigger maternal mortality disparity gap between White women and Black women. “It’s because for White women, the risk drops so much during this period, but it doesn’t drop for Black women,” Bentley-Edwards said. 

Bowie was 32. Her autopsy suggests it is possible she died from complications related to eclampsia, a severe form of preeclampsia that can cause seizures. Bentley-Edwards points out that Black women have similar levels of occurrence of preeclampsia compared with White women. But in Black women, the occurrences are often more deadly, likely because doctors, nurses and other medical professionals are more likely to ignore their concerns until it is too late. 

“I want to make it clear that Black women are not predisposed. It’s not a biological thing. Racism is social, so we have to look at the social conditions that make this a heightened prevalence for Black women,” she said. 

Bentley-Edwards emphasized the critical importance of doulas like McCant, especially for pregnant people who may feel like they have no other support systems. “A doula can be used no matter what type of birth or in most birth conditions. …They provide support to you, but they are also your advocate in the birthing space,” she said. 

But McCant also emphasized the need for more doula support. “We need more doulas actively trained and certified and ready to rock and roll. We need more doulas who have trauma-informed care. We need funding for these doulas and the community-based organizations that support the training and development of the doula workforce,” she said.

She finds encouragement in the fact that a doula pilot program was recently launched in Florida— one in which she will provide training and mentorship for – but she also realizes that it took far too long for this program to be developed. 

“At the rate things are going, we have a shortage,” McCant said. “The federal government has realized that. They want to invest in this way. But we also need legislation within every state, especially in our state, to make it readily available for those who are already on the ground doing the work.”