SportThe Olympic sprint champion died during childbirth earlier this year. But she was far from an anomaly in a troubled US health system
The last time Tianna Madison saw Tori Bowie alive was at a meet in Gainesville, Florida. This was in April 2021 – back when the rival sprinters were on separate quests to regain the form that powered them to gold in the 4x100m at the 2016 Olympics. Bowie was one of track and field’s most striking personalities, a speed demon as well as a style icon, the elite runner whose go-to accessory was a colorful hair scarf. Madison always looked forward to sharing the spotlight with her. There were hugs, pleasantries and no hard feelings when Madison beat Bowie in the 100m – the pair finished second and ninth, respectively
“At a meet, I always want to circle back and catch up with people,” Madison says. “But it’s also work; you race, you’re sweaty, exhausted, hungry …”
Madison figured she’d run into Bowie again at the US Olympic Trials, where a ticket to the Tokyo Games was on the line. But when Covid restrictions finally let up and the country’s best runners converged on Eugene, Oregon, in June 2021, Bowie was nowhere to be seen. Once a fixture on the big stage, Bowie’s attendance at races tapered off. After that April meet in Gainesville she only competed three more times over the ensuing 13 months. This past May sheriff’s deputies in Orange county, Florida, discovered her dead inside her home after no one had seen or heard from her for several days. An autopsy found that the 32-year-old had died while eight months pregnant, after going into premature labor. Her baby girl, called “Ariana” in Bowie’s funeral program, was stillborn.
The tragedy has Bowie’s friends and colleagues in the track and field community grasping to make meaning out of her loss without reducing her legacy to cliche.
“Her life was so much more than her death,” says Sanya Richards-Ross, the NBC Sports analyst who briefly overlapped with Bowie at the tail end of her own gilded sprint career. “She was an overcomer and a victor.”
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In death, however, Bowie has become something else: a symbol of a US child birthing epidemic that has reached crisis point. According to a 2021 CDC report, there was a 40% rise in maternal deaths in the US over the previous year. Some will be tempted to chalk that final figure – 32.9 maternal deaths per 100,000 live births – to the pandemic. But discounting that nonetheless puts the US’s maternal mortality rate at about 10 times the rate of countries such as Australia, Japan and Germany. The danger is even more acute for Black women, who are three times more likely than their white counterparts to die from pregnancy-related causes in the US. Much of that disparity comes down to health providers ignoring Black women’s birthing preferences and concerns.
Beyoncé and Serena Williams are two prominent Black women who have pulled back the curtain on their harrowing experiences in labor over the years. Madison and compatriot Allyson Felix have openly discussed their own close calls in the delivery room, too. Had Bowie lived, her becoming the third member of Team USA’s golden girls relay squad in Rio to face a traumatic childbirth after Felix and Madison probably wouldn’t have become worldwide news. But in death, Bowie gave a human face to a devastating problem and made it stick.
Here was a double world champion and one of the fastest women ever, dying from something women all over the planet go through every day. The postmortem attributed Bowie’s passing to complications from respiratory distress and eclampsia, a high blood pressure condition infamous for stalking pregnant Black women. The report further noted Bowie’s history of bipolar disorder. Mental health problems are a known maternal mortality accelerant; the CDC links them to nearly a quarter of the pregnancy-related deaths between 2017 and 2019.
Bowie’s manager, Kimberly Holland, who also spoke to the Guardian at length, said her client skipped prenatal appointments expressly to avoid hospital care; this was despite Bowie having insurance and the financial means for first-rate medical care. Such wariness is commonplace among Black Americans and well earned with Black women. The so-called “father of gynecology,” a US physician named J Marion Sims, was an unrepentant eugenicist whose anesthesia-free experiments on “clamorous” women and girls in slavery continue to guide conventional medical practice. This year Los Angeles’s Cedar Sinai Medical Center became the focus of a federal civil rights investigation after a woman bled to death following a 17-minute C-section. (The case is ongoing.)
Kamala Harris has made the maternal mortality crisis a Biden administration focus, but her proposals have struggled to garner legislative support; the Momnibus Act, Congressional Democrats’ attempt at the same reforms, hasn’t fared any better. Among the likely sticking points is the call for implicit bias training for medical practitioners. “Data [from medical health associations] tells us that when they have questioned medical students, a significant number of them still carry biases around – whether Black people have a different pain threshold,” Harris said in a recent interview with the BET news program America in Black. “I mean, it’s shocking to think that that is … possible.”
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Madison is intimately familiar with the crisis. She had hoped to sidestep the trauma by never becoming a mother in the first place. “I was gonna be Rich Auntie,” she jokes. “I wasn’t willing to risk it.”
That changed in 2021, a year that saw her compete at the US Olympic Trials while two months pregnant – and place 10th in the long jump. Madison figured her world-class conditioning and smarts would keep her from becoming another statistic.
“But knowledge doesn’t save you,” she says “The first call I had with the doctor’s office before they met me, when they’re doing intake, as soon as I said ‘African American, 36 years old,’ they were like: ‘Cool, let’s schedule your C-section.’”
But that plan was thwarted when Madison went into labor in her second trimester. She rushed to the hospital holding her last will and testament and clear instructions for her partner – Charles Ryan, an assistant track coach at the University of California, Berkeley – to prioritize her life if doctors forced him to choose between mother and child. But even with a new plan in place, she says, “I was not confident I was coming home.”
In the end, Madison delivered a boy named Kai three months premature; doctors kept him in neonatal intensive care until his due date. Throughout, Madison remained on edge – and was nearly pushed past her breaking point when Ryan floated the idea of one last track comeback. “Because he came so early,” Ryan started, “you have time to train and get back …”
Madison’s reply: “If you don’t get out of my face …”
She laughs at the moment now. “He thought that highly of me where he 100% believed that if I wanted to come back, I could,” she says. “But that calculus is always there for athletes. That calendar, that timeline is always on your mind.”
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Richards-Ross, the 400m champion whose career was winding down as Bowie’s was revving up, wasn’t in a rush to have kids, either. In 2008 she had an abortion within hours of boarding a flight to compete in the Beijing Olympics – and was notably upset in the 400m final. She’d spend years coming up with petty excuses for the defeat in the final before coming clean about the abortion in a 2017 memoir, Chasing Grace. When the four-time Olympic champion wasn’t being judged by her fellow Christians for her decision, she was taking heat from other track stars for saying “every female athlete I know has had an abortion.”
“What I was trying to do is bring awareness to the stories of women I knew personally who had had similar experiences, largely because of misinformation, or lack of information or lack of resources,” she says. “But there’s been a huge shift since then. A lot of women have babies now and return to the track in such profound and dominant ways that you no longer feel as if you have to make a choice.”
Ultimately, Richards-Ross held back on starting a family until her retirement from the track in 2016, at the age of 30. After “a beautiful, uneventful pregnancy,” she assumed her delivery would be a breeze. But when her labor dragged on past 24 hours, doctors elected for an emergency C-section. “It was very scary,” she says. “I had wanted to have this natural childbirth, but now I had to get all this medicine. It was crazy.”
Richards-Ross considers herself fortunate to have escaped major complications from giving birth to her son Aaron Jr, whom she calls Deuce. But after the surgery, which left psychic bruises along with the abdomen scar, Richards-Ross was not about to tempt fate again. She expected to stay a one-and-done mom and stuck by that decision until her husband, the two-time Super Bowl-winning cornerback Aaron Ross, brought his case for another baby. It was caught on camera for her debut season on the Real Housewives of Atlanta – where pregnancy challenges have been a recurring theme within the show’s Black cast.
It’s not lost on her, either. “I’m a firm believer and an optimist,” Richards-Ross says. “But even with all those things I also have the humility to know that just as someone else didn’t make it, that could’ve been me. So, yeah, I do have a little bit of fear. We’re going to be doing our due diligence as far as the things I can do to give myself the best chance – but, obviously, it’s never guaranteed or perfect.” Not long after we hung up, Richards-Ross announced she was pregnant again in a mid-season trailer for the Real Housewives show.
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It’s difficult to imagine Bowie willingly taking on an issue as big as maternal mortality. Apparently, underneath her world-beating confidence, beat the heart of a small town Mississippi girl who had been questioning her sense of belonging since her grandmother rescued her from foster care at the age of two. According to Holland, the manager who came to regard Bowie as a daughter, Holland was the one talking up Bowie before her career-defining track meets and her pinch-me profile in Vogue and Annie Leibovitz photoshoot, and her Adidas collaborations with the super producer Pharrell and A-list designer Stella McCartney. Impostor syndrome might well have been Bowie’s most formidable opponent. She beat it more often than not.
Madison recalls coming away from that meet in Gainesville feeling like Bowie was in a good place.
“I knew she was training with Brooks Johnson, who I had trained with before. And I kinda felt like he was taking care of her heart,” says Madison. “I was really happy to see her. I’m so glad we were able to have that moment then.”
Still, the rival she faced that day was a shell of the speed queen who had once dominated the track in style. She forewent her trademark scarf and long hair for a short and simple bob. Her fingernails, usually on point, weren’t even painted. “Muted” is the way Madison remembers her. After the race, Bowie disappeared.
Madison says she feels a responsibility to carry the maternal mortality movement forward. Fresh off completing a degree in social work at the University of Tennessee (where she led the Lady Vols to their first NCAA title in a sport other than basketball), Madison now intends to make advocating for Bowie and the multitude of women in danger the focus of her social work career. If there’s reason to believe the maternal mortality crisis can be curbed, it’s because the CDC claims 84% of pregnancy-related deaths in the US are preventable.
“I believe in turning pain into purpose,” she says. “There’s been so much of it in my personal life and in society. This is a flash point, and we can take advantage. I have to believe this can get better. To think otherwise is unacceptable.”
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