This story was originally published on April 28th by THE CITY.
Amber Isaac, seen with partner Bruce McIntyre, passed away shortly after giving birth at the Montefiore Medical Center in The Bronx. Photo: Courtesy of Bruce McIntyre
Weeks before she gave birth, Amber Isaac, 26, told her partner she dreamed she wouldn’t survive the delivery.
After learning she was pregnant with her first child, the West Bronx resident, a graduate student at Concordia College, spent months poring over information on maternal death. Black mothers in the U.S., she read, died at a rate three to four times higher than white ones.
“She had mentioned to me that she feels like she’s not gonna make it,” her partner, Bruce McIntyre, 28, told THE CITY. “And I would try my best to cheer her up. She would tell her mom she’s really glad the baby is healthy, but she’s scared that she’s not gonna make it.”
Isaac’s premonition came true just after midnight on Tuesday, April 21, when she died shortly after delivering her son, Elias, at Montefiore Medical Center in The Bronx.
She died without any loved ones around, but not far from McIntyre, who said he was barred from being present for her emergency C-section because doctors administered a general anesthetic.
Some hospitals permit only medical staff into a delivery room where a general anesthetic is used, or in an emergency, said childbirth experts.
From a spot nearby, McIntyre, 28, could hear the clamor of staff rushing in and out of the delivery room and PA announcements urging doctors to report there, he said.
“As soon as they took the baby out, her heart stopped,” he said. “And she bled out. Her platelet levels were so low that her blood was like water, so nothing was clotting.”
A Last Tweet
Isaac’s platelet levels had been falling since February, according to McIntryre. And while she was seven months pregnant and “knew she needed to be seen,” he said, the hospital had been holding video meetings with her in lieu of office visits in March because of the COVID-19 pandemic.
McInytre, who said he regularly drove her to her appointments, said he was not sure whether she had any bloodwork done that month.
According to McIntyre, after follow-up calls and emails from Isaac asking to see a doctor, doctors asked her to come in for a visit in April — her first in-person appointment since late February.
On April 17, she found out her platelet count had dropped yet again and was admitted to Montefiore, McIntyre said.
She sent what would be her final tweet that day.
“Can’t wait to write a tell all about my experience during my last two trimesters dealing with incompetent doctors at Montefiore,” she wrote.
Doctors induced labor on April 20. That day, Isaac learned she had HELLP syndrome, a group of serious symptoms that can complicate a pregnancy, McIntrye said.
“They wouldn’t let me hug or kiss her because I had masks and stuff on,” he said. “So I told her I loved her and we were gonna get through this.”
Their son, born more than a month early, is alive and healthy, McIntrye said, but still in the hospital.
Montefiore Medical Center did not respond to multiple requests for comment.
The family is currently crowdsourcing donations for Isaac’s newborn son — and for her funeral. McIntrye has launched a #JusticeForAmber campaign to raise awareness around maternal death.
Pandemic Worsens Issue
Isaac’s case is not an uncommon one, particularly in New York City, where black women are eight times more likely to die due to complications related to pregnancy than white women — a figure even higher than the disparity seen at the national level.
This tragic gap may be worsened by the COVID-19 outbreak, which has overwhelmed local hospitals and depleted blood banks — and, some health experts said, stressed resources and support for those who give birth in hospitals.
When health care providers began to take steps to mitigate the spread of COVID-19, the American College of Obstetricians and Gynecologists advised doctors to “be aware of the unintended effect they may have, including limiting access to routine prenatal care.”
The guidance suggested that medical professionals “maximize the use of telehealth” tools, like video calling, “across as many aspects of prenatal care as possible.”
Dr. Aimee Mankodi, a family medicine practitioner and maternal care director at the Institute for Family Health, calls telehealth a “wonderful option” for many pregnant women, but added, “When you have high-risk pregnancies, you have to double down and try to really move fast, especially during COVID.”
Said Mankodi, “You can’t sit on a patient, because of all the distractions and everything that’s happening.”
Some hospitals have adjusted their schedules so pregnant patients can still see doctors, even though most facilities have limited non-essential visits, Mankodi said.
While Mankodi utilizes telehealth tools, patients still come in for some key appointments, including when they are 28 and 32 weeks pregnant. In the last four weeks of pregnancy, her patients are seen in person each week. And if at any point an issue has surfaced in a patient’s lab work, Mankodi said, additional testing is done.
Montefiore also declined to comment on any adjustments it has made to care because of the COVID-19 outbreak, separate from Isaac’s case.
‘Absolutely Exacerbating’
Some who work with those who are pregnant say it’s likely the pandemic is having some impact on quality of care.
But even before the current crisis began, black parents often reported being dismissed by medical professionals when they experienced pain, discomfort, or other issues during pregnancy, said Brooklyn doula Evelyn Alvarez, co-founder of Black Magic Doulas.
“Being a person walking into the hospital, you should be guaranteed a certain standard of care,” Alvarez said. “You should feel comfortable with being able to feel like ‘I have confidence that my provider is caring for me optimally.’”
But that does not always happen, birth coaches said.
“There’s always been so much to say about birthing while black, and then now you’ve got the whole birthing while black during a pandemic scenario that is unfolding,” said Nicole JeanBaptiste, lead doula and founder of the Bronx-based Sésé Doula Services.
“COVID-19 is absolutely exacerbating — and going to be exacerbating — this crisis,” she said.
Another Task Force
State officials announced on April 20 — the day Isaac’s son was born — that they were convening a COVID-19 maternity task force to determine how to roll out dedicated birthing centers in the state, to provide an alternative to delivering in hospitals during the crisis.
“This pandemic strained our hospital system in a way no one could have ever imagined,” said Melissa DeRosa, secretary to Gov. Andrew Cuomo, in a statement announcing the launch.
Cuomo previously launched a maternal mortality racial disparity task force in 2018, and the group made a batch of recommendations in March 2019. It remains unclear how much progress has been made.
The new task force does not include any doulas. Some who spoke with THE CITY questioned whether it would develop recommendations tailored to the unique needs of those most vulnerable to dying during childbirth, or if officials would use death disparity data to inform the location of birthing centers.
“The system is designed to support the people that can afford support, and that have the loudest voices,” said Jesse Pournaras, the doula whose change.org petition pushed the state to permit partners, spouses and friends in hospital delivery rooms during the coronavirus outbreak.
“If you look at the petitions I made, the first one, the one that gained so much traction, if you look at the little icon of the faces of the people that signed it and commented on it — the people that feel like they have the right to a respectful, safe, dignified birthing process are white,” she said.
“The system has been so long biased against black women and women of color and LGBTQIA individuals,” she added.
The state task force’s recommendations were due this weekend. A spokesperson for the governor said the group had been meeting frequently.
‘We Love People’
Those who knew Isaac say she was outgoing and ambitious.
“She was meant to do so much more,” said Kattie Guerrero-Valoy, a friend of Isaac’s. “She was so full of love and so much light. And I wish she could be here right now to see her beautiful son.”
“We cannot even grieve the proper way because we’re stuck in the house quarantined,” Guerrero-Valoy, 25, added. “That’s what’s just unfortunate about this. I wanna hold her mom. I wanna hold Bruce (McIntyre). I wanna see her. This — right now, it sucks. It’s very hard.”
McIntryre, who said he had known Isaac for around eight years before their almost three-year relationship, sometimes slips into present tense to talk about her.
“Me and Amber are just — we love people,” he said.
“She was the coolest person. … I wouldn’t have changed anything about her,” he added.
The two eventually wanted to open a day care center that would primarily serve families with limited incomes, he said. Isaac, who was studying business development, hoped to graduate in May.
“She was treated very unfairly,” McIntyre said. “And she died because of that.”