With the state of Mississippi’s maternal and infant mortality rates regularly hovering at the highest in the country, especially for Black women, Sha’Meika McDonald Davis decided to go through her first pregnancy with a midwife at home instead of being in the hospital. Her pregnancy went well, and taking control of her birth location and care was an empowering experience. She became a doting mom in January 2021 to a perfect baby girl.
Sha’Meika and her husband were elated. They had experienced two miscarriages and were overwhelmed with happiness that they had experienced such a holistic and nurturing process to the birth of their healthy daughter. At the time, Sha’Meika and her husband owned a private practice mental health clinic, and she was paying for healthcare out of pocket.
She was technically unemployed since she wouldn’t see clients for three months of maternity leave. Her unemployment status meant Sha’Meika and her daughter qualified for Medicaid. Now that Sha’Meika had these benefits, she thought it best to use them while she had them. She began to use it for her routine annual OBGYN visits. Unbeknownst to her, the quality of care she was used to while paying out of pocket was about to do a complete 180.
This February, Sha’Meika became pregnant again. She told the doctor she had selected via her eligible Medicaid coverage and informed them of her history of miscarriages. Her midwife had suggested her miscarriages were a result of low progesterone levels. Sha’Meika started taking progesterone from weeks five to 36 of her pregnancy.
She asked the OBGYN if she needed to continue taking it for this pregnancy to prevent another miscarriage. The medical office told her the earliest available appointment was almost two months out. Sha’Meika felt that it was too long to wait. She asked if they could call it in for her since it would not harm her health. Despite her concerns, the office told her she would need an appointment to get a prescription. Sha’Meika felt this put her and her unborn child’s health at risk.
Two weeks later, Sha’Meika began bleeding heavily. She called the doctor’s office to voice her concerns and let them know what was happening. However, she seemed to go unheard. The first nurse she spoke to told her to look out for certain things, mainly if her blood was a bright red. It was. The nurse said she’d talk to the doctor and give her a callback. Sha’Meika called back after not receiving a call after an hour had passed. The office said they’d be able to work her in that day.
Sha’Meika makes it to the appointment. A technician took her ultrasound, but no one told her anything the whole time. A nurse practitioner finally comes in the room with an intern. Neither of them even looks at her. Instead, they tell her they only have one miscarriage on file despite Sha’Meika having a history of them which she had already explained.
The nurse practitioner orders some blood work for Sha’Meika and tells her to return in four days. The office calls Sha’Meika the next day with the blood work results. They tell her they plan to give her an RHoGAM shot during her next appointment. However, it is only effective within 72 hours of exposure, and her appointment was outside that range. Sha’Meika urged them to bump her appointment up, but they did not. In the meantime, Sha’Meika had not been prescribed progesterone or any other medication to help her deal with her situation or the pain. She continued to bleed until her appointment.
Sha’Meika attends her long-awaited appointment on Friday. The obstetrician administers the shot, saying that although research has shown it’s not very effective at that point, they still like to follow through with it. Concerned about what’s going on with her body, Sha’Meika asks the doctor whether a D&C, also known as dilation and curettage, a surgical procedure often performed after a first-trimester miscarriage, would be needed. The doctor told her it wouldn’t because things seemed to be taking their natural course. The doctor says they will follow up in April for her annual as scheduled, and that was it. The medical staff showed little compassion or concern for her health or the child she’d lost.
The following week, the obstetrician called again and told Sha’Meika that her blood work showed that her factor V Leiden, a mutation of one of the clotting factors in the blood, was abnormal and could be related to her miscarriages. She was referred to a hematologist. However, that appointment was more of the same. The hematologist did more blood work but told Sha’Meika that she couldn’t find anything of concern.
Sha’Meika, advocating for her health, said that her nail beds began to appear dark. It looked like blood was clotting under her nails, and she wondered if it was related to the miscarriages. The hematologist glanced at her hands, didn’t acknowledge her concern, and told her she was good to go. Sha’Meika decided to find a new obstetrician, but everyone she called was not taking Medicaid patients.
Sha’Meika gave up on Medicaid altogether. She would rather pay out of pocket than receive inadequate care. Her dramatic experiences drove her, not to mention her Medicaid coverage, to providers.