The news that Serena Williams experienced scary complications after giving birth was shocking—not to mention influential in highlighting the racial and economic disparities in health care in the U.S.
Now, in the first few episodes of the new HBO docuseries Being Serena, which premieres Wednesday night, we find out that there was even more to Williams' pregnancy story. Being Serena is a five-part series following Williams from the moment she found out she was pregnant through her return to tennis (SELF received screeners of the first two episodes before they aired). It offers a look into her relationship with now-husband Alexis Ohanian, her experience becoming a mother and getting married, and the pressure she puts on herself to come back and consistently be one of the greatest athletes of all time.
But what struck us the most in the first two episodes was how much we get to see of Williams' labor and delivery—and the subsequent complications. Here are a few details you may not have known about Williams' journey to motherhood (Beware: Spoilers ahead.)
Even though Williams put on a brave (and remarkably relaxed) face, she felt anxious about the health of her baby throughout her pregnancy.
In the first episode, you see a pregnant Williams describe her experience as not too challenging overall. She says she has plenty of energy (and continues to work out well into her pregnancy) and hasn't had any horrible morning sickness, although she does mention that even water gives her heartburn later on.
Still, she was fairly nervous throughout the experience. "I have a lot of fear and hesitation mostly around the health of the baby," she says before giving birth. "That's my main concern."
Williams knew she wanted to avoid a C-section if possible, mainly due to her history of blood clots.
In a filmed conversation, Williams goes through her birth options with Caroline Bahadourian, her doula. Bahadourian explains that recovery from a C-section can be challenging for anyone, but considering Williams' previous health issues ("embolisms, hematomas, blood clots..."), there may be a risk for certain complications after a surgery like a C-section.
A little background info: Blood clots form when blood thickens into clumps, the Mayo Clinic explains, which happens normally when you're healing from a wound. But it can also happen after surgery because you're not able to move around a whole lot and get your blood flowing. If those clots break off, they can move around your body to potentially harmful locations, including the brain or lungs, and block blood flow to those areas (forming an embolism or hematoma). If you have a history of blood clots, you may be at risk for getting them again, especially after undergoing major surgery.
"The C-section was low on our wishlist because of her history of blood clots," Ohanian explains in the episode. "Any surgery that Serena has is potentially life-threatening." So the couple says they would prefer to give birth vaginally.
Ohanian jumped into action the moment they knew something wasn't quite right.
About halfway through the first episode, Ohanian drives Williams to the hospital to be induced. But after the first night in the hospital having contractions without her water breaking, it's clear that her delivery may be a bit more challenging than they were hoping.
The next day, Ohanian calls in a nurse to check on their "little machine" that's beeping, because they're not sure what's going on. "We're watching the baby's vitals start to drop when the contractions were happening," Ohanian explains later. "[The] baby was in distress."
According to Williams' agent, Jill Smoller, "Serena said her chest was hurting, she had a lot pain." The doctors determined that "between the stress and the baby, they were not taking a risk [with a vaginal birth]." Although the couple had previously decided that a C-section wasn't their first choice, "for the safety of mom and the safety of the baby, we have to proceed with a C-section," Ohanian says.
That's when Williams knew she wasn't going to be able to have her baby vaginally, she says in an on-camera interview reflecting on her birth experience. "I was terrified. It was a whole new kind of fear," she says. "Tennis...I don't think it ever felt so far away, and I don't think my life ever felt so unsure."
Williams experienced serious complications after giving birth, and needed two more surgeries after the C-section.
As SELF reported previously, Williams developed a pulmonary embolism after her surgery, meaning that a blood clot had made its way to her lungs. "I just remember getting up and I couldn't breathe, I couldn't take a deep breath," Williams recalls in the second episode. She told a nurse she needed an oxygen mask on, but when she put it on, she started coughing and her C-section stitches came undone.
She was wheeled back into the operating room so they could re-stitch up her C-section wound and run tests for blood clots, which all came back negative. But Williams, who had previously dealt with a pulmonary embolism in 2011, told the team that she needed a CT scan with dye. "I'm not someone who takes their health for granted," Williams says. "With as many issues and scares as I've had, I think I've learned pretty well how to listen to my body."
Ohanian later says that she was "undoubtedly battling for her life" and that she was "terrified she might die." But at the same time, he "was grateful that she had the wherewithal to speak up because she knew her body better than any of us."
Unfortunately, even after identifying her pulmonary embolism, the complications didn't end there.
Williams says she developed other clots, including one in her leg. Eventually, she needed a third surgery to temporarily place a filter that blocked blood clots from reaching her heart. "Every day I was in the operating room for something different," she says.
Clearly, this wasn't how she and Ohanian had expected things to go. But since her experience, Williams has spoken openly about the complications she dealt with—and received feedback that many people have experienced similar issues.
Williams recently reiterated just how happy she is to have her daughter, Alexis Olympia, here safe and sound. To see the full story, check out the premiere of Being Serena Wednesday on HBO at 10 p.m. EST.