Members of the medical community at Indiana University School of Medicine are mourning the loss of Chaniece Wallace, MD, a fourth-year pediatric chief resident there, after she died from pregnancy complications last week.
Around 35 weeks into her pregnancy, Wallace developed symptoms of preeclampsia. Her baby was delivered via C-section, but Wallace had subsequent complications -- including a ruptured liver, kidney function issues, and high blood pressure -- and required additional surgeries. She died on Oct. 24, four days after her daughter, Charlotte, was born.
"Chaniece fought with every piece of strength, courage, and faith she had available," said Wallace's husband, Anthony Wallace, on a to raise money for their daughter. He stated that his wife was a warm soul, and "had a special way of being empathetic with her patients and making each one of them feel special."
Wallace dedicated her career to empowering children and families. She finished her residency training in June, and was in the midst of deciding on next steps. Her residency director and colleague, Jerry Rushton, MD, said that Wallace was dedicated to treating underserved communities.
"People really saw her as 'their doctor,'" Rushton said. "They trusted her, and wanted to come back to see her." One of Wallace's goals was to increase medical literacy in underserved communities, Rushton said, and he always noticed her unique ability to connect with patients, even from the start of her training.
"She did some amazing things in her short life and short career, and was just getting started," Rushton added. "That's something we hope to honor her memory by, building on that legacy."
The death of Chaniece Wallace, a Black woman, highlights a tragic trend in pregnancy and childbirth outcomes in the U.S. About 700 women die from pregnancy-related causes each year, and the maternal mortality rate is higher in the U.S. than in any other industrialized country in the world. People of color die from pregnancy at an alarming rate, with Black, Native American, and Alaskan native women than white women.
Medical professionals have long recognized that the U.S. maternal mortality rate is a problem. But Wallace's death has again brought attention to an issue where the country has made little progress.
"Black birther mortality is yet another public health crisis that the U.S. has allowed to persist for too long," Farrah-Amoy Fullerton, a fourth-year medical student at University of Alabama at Birmingham, in response to Wallace's death.
Linda Burke-Galloway, MD, that Wallace worked as a physician in a state with one of the worst maternal mortality rates in the country, stating "we need to fix this, please."
"Dr. Chaniece Wallace just completed her pediatric boards and was exploring jobs before dying postpartum," Rebekah Fenton, MD, pediatric fellow at the Northwestern Feinberg School of Medicine. "Our medical training can't save us."
Lauren Dungy-Poythress, MD, a maternal-fetal medicine specialist at Indiana University, said "it certainly strikes home very quickly when it's a maternal loss, and when it's a woman of color, it strikes home as well."
Dungy-Poythress, who did not know Wallace personally but was notified of her death from the health system, said the cause of her death, preeclampsia, can be manifest in a number of ways, including high blood pressure, headaches, blurred vision, epigastric pain, vomiting, protein loss in the urine, or swelling in the hands and face.
"Preeclampsia can present any way it wants to," Dungy-Poythress told 鶹ý. While there is a classic triad of symptoms -- hypertension, proteinuria, and edema -- she added that other symptoms, like severe and consistent headaches, should be a warning signal for clinicians.
Dungy-Poythress said that healthcare providers should be looking for these warning signs at every birth. "But the question is, do Black mothers get the care or scrutiny that they need?"
Racial disparities in maternal mortality outcomes may occur in part because of the chronic stresses that people of color endure from constant discrimination which can take a toll on their health -- a concept called weathering.
"You can be a healthy Black woman, and still have a higher risk of maternal mortality," Dungy-Poythress said. "What Dr. Wallace unfortunately highlights is that it's not based on access to care."
While the community at Indiana University continues to grieve over Wallace's death, Rushton, the residency director, said they are taking a few actions to preserve her legacy. Indiana University will organize a book drive in her honor, as Wallace encouraged literacy and doing well in school among her patients.
Rushton continues to mourn the loss of Wallace as a friend, but he added that he is also grieving the loss of her work.
"2020 has been a hard year, and kids have taken on a disproportionate impact of some of the challenges in our country today," Rushton said. "We have one less warrior in that fight."