Pregnant women in New Orleans are violently injured at 3 times national average, analysis says | Crime/Police

If everything had gone to plan, 29-year-old Harmonese Pleasant would have given birth to a baby girl right around now, considering her due date was April 9.

Instead, Pleasant’s child with New Orleans trumpeter Kermit Ruffins entered the world early after Pleasant was shot in front of their Treme home on March 25. A few days after the shooting, Pleasant and her daughter were recovering, Ruffins said on social media, but the newborn still had three bullet fragments in her tiny body, according to a report from WWL.

The motive for the shooting is unclear and has baffled Ruffins, who could not be reached for comment but said on social media Friday they “don’t have the slightest idea” why Pleasant was in the line of fire. 

Trumpeter and businessman Kermit Ruffins is seen in New Orleans, La., on Wednesday, Nov. 3, 2021. (Photo by Max Becherer,, The Times-Picayune | The New Orleans Advocate)

But for those who study trauma closely in New Orleans, it was not a surprise. Pregnant women are injured more in the city than most other places, according to a growing body of data, including the number of pregnant patients in need of care for violent injuries in New Orleans. 

“No one is immune to gun violence,” said Dr. Sharven Taghavi, a trauma surgeon and assistant professor at Tulane University School of Medicine. “We need to act as a community, we need to do something. Otherwise, we will all one day be a victim.”

Pregnant women face violence in New Orleans at 3 times national average

Between 2008 and 2021, 148 women arrived at University Medical Center, the city’s only level-one trauma center. They had injuries severe enough for trauma activation, which is when doctors and nurses swarm an injured body trying to assess and repair the damage.

Many of those trauma visits are a result of accidents. But a large number of them – about one-third – are what trauma surgeons call “penetrating trauma,” when an injury is caused by an object that pierces the skin.

Of those, most are gunshot or stab wounds, according to Dr. John Tyler Simpson, a fourth-year surgical resident at Tulane University conducting an analysis of traumatic injuries in pregnancy. Violent injuries requiring trauma care occur in 28% of pregnant trauma patients at University Medical Center, about three times the rate of the national average.

Those are just the women who make it to the hospital. Louisiana’s death rate for pregnant women is already higher than the national average. In a recent analysis from Louisiana researchers, homicide – not car accidents or common blood pressure conditions like preeclampsia – is the most common cause of pregnancy-related deaths, occurring in about 13.4% of maternal deaths during 2016 and 2017. Compared to non-pregnant women of the same age in Louisiana, the risk of homicide doubles during pregnancy, according to the study. 

Two lives at stake

Sometimes in these situations, one trauma patient becomes two, when an injury penetrates the uterus in a way that requires delivery of the baby. About 4% of the time, the mother dies after arriving to the hospital, the analysis found. Always, it is an emotionally and physically draining experience for the patient and care team with two potential lives at stake.

“Taking care of a pregnant patient makes a complicated problem even more complicated by a huge margin,” said Dr. Patrick McGrew, a trauma surgeon at UMC who also worked on the analysis.

Shooting on Treme Street

Crime scene tape is strung across the 1300 block of Treme Street in New Orleans after a woman was shot there Thursday, March 24, 2022.

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Pregnant women have physiological differences that make trauma care more complicated – the uterus is taking up space it normally wouldn’t, and there are higher risks of blood loss and clotting, said McGrew. And statistically pregnant trauma patients are more likely to have longer stays and require intensive care and ventilation, even though they’re typically young and healthy prior to the trauma.

Medical guidelines stipulate that the life of the mother is prioritized. If the mom isn’t doing well, the baby has a much lower chance of survival. In about 1 in 10 cases, the fetus doesn’t make it, according to the UMC analysis. Giving the family that news is heart-wrenching, said Taghavi, recalling a case from several years ago.

“We really couldn’t do anything to help the fetus until we were sure that mom was okay,” said Taghavi. “In the end, we ended up losing the baby and later had to deliver.”

Preventing violence

Taghavi is a co-investigator of a new violence prevention initiative created by Tulane University called the Center for Youth Equity, a collaboration between community organizations aimed at preventing youth exposure to violence. It is one of five new centers funded by the CDC with newly available federal funding, which until recently was not available for gun research.

One goal of the center is to research how to reduce community rates of gun violence starting in hospitals, said Julia Fleckman, the associate director of the Violence Prevention Institute at Tulane. But the root of gun violence runs deep, and New Orleans’ high rate of shootings among pregnant women and unintended victims is a reflection of overall community violence.

“People don’t just shoot people or experience firearm violence in a vacuum,” said Fleckman. “There’s a lot of structural and social issues that lead to that point and some of those primary drivers we’re thinking about are housing instability, access to mental health services, financial security.”

File pregnant woman

Image via Pixabay

New Orleans’ high levels of poverty and natural disasters increase the likelihood of distress, experts said. Combined with a lack of gun policies in Louisiana that require background checks or safety measures, that’s a recipe for firearms injuries to ripple out across the city, said Fleckman, leading to more interpersonal violence, community violence and unintentional injuries.

More guns, more violence

A recent study out of California showed that simply living with a gunowner increased the likelihood of homicide nearly three times. And the risk fell almost entirely to women – almost 85% of homicide victims living with gun owners during the 12-year study were women.

Domestic violence is often the cause of violence among pregnant patients, trauma surgeons said. Interpersonal violence is normalized, said Fleckman, often exacerbated by a legacy of violence.

“You’re hurt and hurt the people closest to you,” said Fleckman. “That’s how that works.”

In 2017, Louisiana had the second-highest rate of female homicide behind Alaska. 

“It’s intergenerational, and you see that really in New Orleans,” said Fleckman. “How does that pass down? We’ve got to disrupt that in some way.”

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