(NEW YORK) — Tennis superstar Serena Williams is describing in her own words the life-threatening complications she faced while giving birth to her daughter, and how she advocated to save her own life.

Williams, 40, gave birth to her daughter, Olympia, with husband Alexis Ohanian, in September 2017, in an emergency cesarean section.

In the new book Arrival Stories: Women Share Their Experiences of Becoming Mothers, a collection of essays helmed by Amy Schumer and Christy Turlington Burns, Williams writes, “Giving birth to my baby, it turned out, was a test for how loud and how often I would have to call out before I was finally heard.”

Williams writes in her essay, an adaptation of which was published by ELLE.com, that after her C-section, she underwent three surgeries due to complications that included an embolism, or clot, in one of her arteries, and a hematoma, a collection of blood, in her abdomen.

She describes in the essay what she remembers happening the day after she gave birth, when the complications began.

“In 2010, I learned I had blood clots in my lungs—clots that, had they not been caught in time, could have killed me. Ever since then, I’ve lived in fear of them returning. It wasn’t a one-off; I’m at high risk for blood clots. I asked a nurse, ‘When do I start my heparin drip? Shouldn’t I be on that now?,'” she wrote, referring to a drug that is delivered by IV and helps to prevent blood clots. “The response was, ‘Well, we don’t really know if that’s what you need to be on right now.’ No one was really listening to what I was saying.”

“The logic for not starting the blood thinners was that it could cause my C-section wound to bleed, which is true. Still, I felt it was important and kept pressing,” she wrote. “All the while, I was in excruciating pain. I couldn’t move at all—not my legs, not my back, nothing.”

Williams said at times she felt like she was dying, but she insisted to a nurse that she get on a heparin drip and have a CAT scan done on her lungs.

“Finally, the nurse called my doctor, and she listened to me and insisted we check. I fought hard, and I ended up getting the CAT scan. I’m so grateful to her,” said Williams. “Lo and behold, I had a blood clot in my lungs, and they needed to insert a filter into my veins to break up the clot before it reached my heart.”

The discoveries from the CAT scan led Williams to undergo her third and fourth surgeries. One week later, she was discharged from the hospital and able to go home with Olympia.

Williams writes that she believes it was because she was “heard and appropriately treated” that her life was saved.

“In the U.S., Black women are nearly three times more likely to die during or after childbirth than their white counterparts. Many of these deaths are considered by experts to be preventable,” she writes. “Being heard and appropriately treated was the difference between life or death for me; I know those statistics would be different if the medical establishment listened to every Black woman’s experience.”

The United States has the highest rate of maternal mortality among developed nations, data shows, with a growing and disproportionate impact on women of color.

Black women are more likely than white, Asian or Latina women to die from pregnancy-related complications regardless of their education level or their income, data shows.

One reason for the disparity is that more Black women of childbearing age have chronic diseases, such as high blood pressure and diabetes, which increases the risk of pregnancy-related complications like preeclampsia and possibly the need for emergency C-sections, according to the Centers for Disease Control and Prevention.

But there are socioeconomic circumstances and structural inequities that put Black women at greater risk for those chronic conditions. And Black women often have inadequate access to care throughout pregnancy, which can further complicate their conditions, according to a 2013 study published in the American Journal of Obstetrics and Gynecology.

In December, when the Biden administration issued a “nationwide call to action” on the maternal health crisis in the U.S., Vice President Kamala Harris called the “systemic inequities” that affect pregnant people of color a “matter of life and death.”

“Regardless of income level, regardless of education level, Black women, Native women, women who live in rural areas, are more likely to die or be left scared or scarred from an experience that should be safe and should be a joyful one,” said Harris. “And we know a primary reason why this is true — systemic inequities, those differences in how people are treated based on who they are, and they create significant disparities in our health care system.”

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(NEW YORK) — April is Autism Acceptance Month, a time to embrace the differences of people with autism spectrum disorder (ASD), a developmental disability that impacts roughly one in 44 children in the United States, according to a study from the Centers for Disease Control and Prevention.

For Eric Garcia, a Washington, D.C.-based journalist and the author of the book We’re Not Broken: Changing the Autism Conversation, it’s also a time to remember that people with autism are “everywhere.”

“Autistic people work in every sector,” he told ABC News’ Good Morning America. “They’re doctors and lawyers and waitresses. They’re car mechanics. They’re journalists. They’re everywhere.”

Fashion designers Tommy and Dee Hilfiger said three of their seven children have been diagnosed with ASD.

The couple said they first noticed signs of autism in their kids early on.

“Our son was counting steps at one-and-a-half years old and at 2, he stopped counting, stopped speaking. He was babbling quite a bit and then just stopped,” Tommy Hilfiger said Tuesday on GMA. “So we had him tested and obviously, it was a bit of a shock. But once you get over the shock, you then plan to do something about it.”

The designer said he and his wife sought out expert advice for each of their children, who have exhibited different symptoms.

He added that one of his top tips for parents is to know the signs of autism in order to be able to recognize them in your child and get help early on.

“Early intervention is really the key,” said Tommy Hilfiger. “If you sense that your child is off in any way … if they’re not responding or if they seem like they’re in their own world, you should get them tested, and the earlier you get them tested, the sooner you can intervene.”

In addition to seeking out expert advice, the Hilfigers say building a support system within the autism community has really helped them as parents.

“I think it’s really crucial that you talk to pediatricians,” said Dee Hilfiger. “And once the child is diagnosed, I think the most helpful thing for us and for other parents is to seek out other parents.”

“When you receive that diagnosis, it can be quite devastating but I think seeking out the support of friends made a big, big difference for us,” she added.

What to know about autism

People with autism have a wide variety of traits affecting communication, behavior and socialization, according to the CDC. The “spectrum” in autism spectrum disorder means that there’s a wide range of symptoms and severity.

A child of any race, socioeconomic status or ethnic group can get ASD. Boys though are four times more likely to be diagnosed with autism than girls, based on a study of children aged 8 years old. Kids that have a sibling with autism, and especially a twin, are more likely to have autism. Those with developmental disabilities or genetic and chromosomal diseases such as Down syndrome are also more likely to have ASD. There is also evidence that kids born to older parents have an increased risk of autism, according to several studies.

Garcia points out that autism “manifests itself in very different ways” in each person with the condition.

For Garcia, he experiences “stimming,” which involves making repetitive movements or sounds, a calming tactic for when one feels overwhelmed. Garcia said for him that can mean playing with his tie and taking his class ring on and off.

“A lot of times I can just completely be overwhelmed and almost want to have a meltdown, like to the point where it’s difficult for me to communicate or speak,” he said. “And that’s just my way to deal with all the sounds that we’re having all around here.”

Autism can be identified as early as infancy, although most children are diagnosed after the age of 2. There is no medical test to diagnose autism, so doctors watch a child’s behavior and development to make a diagnosis, according to the CDC.

“Someone might have the communication delay, but may not have the motor skill delay,” said Dr. Jen Clark, a New York-based clinical psychologist and specialist in autism. “They may experience sounds and lights in a very different way than you and I would and sometimes they can experience a sensory overload and they may wear headphones and this will help to make the noise not as severe, but also they may avoid certain situations where it’s just too overwhelming.”

The CDC notes that in some cases, people are not diagnosed with autism until they are teens or adults.

Experts say though that early detection of ASD is key, as is early intervention.

“When a child is young, the brain is capable of change,” said Clark, also the director of COAST Club, which offers therapy and social groups for children, teens and young adults with autism.

Early signs of autism in children may include, but are not limited to, little or no smiling and limited eye contact by 6 months; little to no babbling, pointing or response to their name by 12 months; and few or no meaningful two-word phrases by 24 months, according to the CDC.

Clark added that children may exhibit additional signs such as flapping of the hands, spinning, twirling and walking on their toes. She also says lining up toys, instead of playing with them in the way they’re intended to be played with, may also be a sign.

“If you do see these behaviors in your child, these are behaviors that are associated with ASD and important to mention to your pediatrician,” she said.

Treatment comes in many different forms, from mental health therapy to occupational, physical and speech therapies. Sometimes medications can be helpful for things related to ASD, like mood problems or inability to focus.

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