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May 04, 2018 05:37 PM

When Serena Williams gave birth to her daughter Alexis Olympia, it was anything but smooth. The tennis champion was rushed to an emergency C-section, and after the delivery, a coughing fit made her wound to reopen and led doctors to discover multiple, life-threatening blood clots in her body.

Williams’ harrowing childbirth experience sounds unusual, but it’s an ordeal that is becoming all too normal for mothers across the United States — and many aren’t as lucky to make it through. The maternal mortality rate has more than doubled over the last 30 years, despite medical advances.

“In twenty-first century America, in the most powerful nation on Earth, no woman should ever die from pregnancy and childbirth. Yet every year in the United States, more than 700 women die from pregnancy-related causes, and more than 50,000 women suffer a life-threatening complication,” Michael Lu, senior associate dean at George Washington University School of Public Health and former director of federal Maternal and Child Health Bureau, tells PEOPLE.

Serena Williams with husband Alexis Ohanian, Sr. and daughter Alexis Olympia
HBO

The rise, he explains, is because women are going into pregnancy with chronic health conditions.

“Nearly one in three American women of childbearing age is obese, a rate twice that in Germany and three times that in France, and obesity is a major risk factor for many of the leading causes of maternal deaths such as hemorrhage, preeclampsia, and thromboembolism,” Lu says. Many women also have high blood pressure or diabetes, that make their pregnancy high-risk.

And women of color and of low socioeconomic backgrounds are at an extreme disadvantage when it comes to proper maternal care. African American women are three times as likely to die from pregnancy and childbirth compared to white women — “a gap we have not been able to close in decades,” Lu says.

The disparity is largely due to the insufficient health care African American women receive before, during and after their pregnancies compared to white women.

“A study in New York City estimated that the rate of life-threatening complications would fall by half if African American women gave birth at the same hospitals as white women,” Lu says.

Serena Williams and Alexis Olympia
Serena Williams/Instagram

Maternal mortality has long gone unspoken, Lu says, leading to the rise over the last three decades, but having more women like Williams talking about it certainly helps.

“Serena Williams’ willingness to speak up about her experience has brought much needed attention to the problem,” he says.

Lu also recommends retraining hospitals and staff to know what to do when there are complications during delivery, creating what he calls “safety bundles.”

“Safety bundles are best practices, protocols, toolkits and other resources designed to improve the quality and safety of maternity care by improving the 4 R’s: readiness, recognition, response and reporting,” he said at a Congressional briefing on April 19.

Lu and his coworkers instituted these practices in hospitals across California, and between 2006 and 2012, the overall maternal mortality rate decreased by 64 percent, and by 50 percent for African American mothers.

“It’s those early successes we had in California that led me to believe that there’s something we can do about maternal mortality for the whole country,” he said.

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