Ciji Graham: Death Due to Lack of Heart Care or Abortion in North Carolina
When Ciji Graham visited a cardiologist on Nov. 14, 2023, her heart was pounding at 192 beats per minute, a rate healthy people her age usually reach during the peak of a sprint. She was having another episode of atrial fibrillation, a rapid, irregular heartbeat. The 34-year-old Greensboro, North Carolina, police officer was at risk of a stroke or heart failure.
In the past, doctors had always been able to shock Graham’s heart back into rhythm with a procedure called a cardioversion. But this time, the treatment was just out of reach. After a pregnancy test came back positive, the cardiologist didn’t offer to shock her. Graham texted her friend from the appointment: “Said she can’t cardiovert being pregnant.”
The doctor told Graham to consult three other specialists and her primary care provider before returning in a week, according to medical records. Then she sent Graham home as her heart kept hammering.
Like hundreds of thousands of women each year who enter pregnancy with chronic conditions, Graham was left to navigate care in a country where medical options have significantly narrowed.
As ProPublica has reported,doctors in states that ban abortion have repeatedly denied standard care to high-risk pregnant patients. The expert consensus is that cardioversion is safe during pregnancy, and ProPublica spoke with more than a dozen specialists who said they would have immediately admitted Graham to a hospital to get her heart rhythm under control. They found fault, too, with a second cardiologist she saw the following day, who did not perform an electrocardiogram and also sent her home. Although Graham’s family gave the doctors permission to speak with ProPublica, neither replied to ProPublica’s questions.
graham came to believe that the best way to protect her health was to end her unexpected pregnancy. But because of new abortion restrictions in North Carolina and nearby states, finding a doctor who could quickly perform a procedure would prove challenging. Many physicians and hospitals now hesitate to discuss abortion, even when women ask about it. And abortion clinics are not set up to treat certain medically complicated cases.As a result, sick pregnant women like Graham are often on their own.
“I can’t feel like this for 9mo,” Graham wrote her friend. ”I just can’t.”
She wouldn’t. In a region that had legislated its commitment to life, she would spend her final days struggling to find anyone to save hers.
Graham hated feeling out of breath; her life demanded all her energy. Widely adm
On the morning of Nov. 19, Scott awoke to a rap on the front door of the apartment he and Graham shared. He’d
A Preventable Tragedy: Delays in care Contributed to Idaho Woman’s Death
An Idaho woman’s death after a miscarriage highlights perilous gaps in medical training and the chilling effect abortion bans are having on care for pregnant patients.Jessica Graham, 36, died in December 2022 from sepsis after a prolonged and ultimately fatal wait for treatment following a miscarriage. Experts say her case reveals a pattern of hesitation among some cardiologists treating pregnant women, often stemming from insufficient education about managing heart conditions during pregnancy.
High-risk pregnancy specialists and cardiologists reviewing Graham’s case expressed surprise at the lack of urgency from her doctor, Dr. Caitlin Custovic. Many noted the decisions mirrored behaviors seen in other cardiologists treating pregnant patients.They attribute this hesitation to inadequate training; a recent survey, developed with the American College of Cardiology, found less than 30% of cardiologists reported formal training in managing heart conditions in pregnancy. “A large proportion of the cardiology workforce feels uncomfortable providing care to these patients,” researchers concluded in the Journal of the American Heart Association.
Doctors also report that legal threats connected to abortion bans are making some cardiologists even more cautious. custovic declined to comment on her training. A spokesperson for Cone Health, where Graham’s physician, Dr. Camnitz,works,stated the hospital’s care for pregnant women with heart disease aligns with regional standards. Despite the family granting permission for discussion, the hospital declined to comment on specifics of Graham’s case.
“There were so many points where they could have intervened.”
– Dr.Amelia Huntsberger, former member of Idaho’s maternal mortality review panel
Three doctors who have served on state maternal mortality review committees, which investigate deaths of pregnant women, told ProPublica that Graham’s death was preventable.