Surprisingly, maternal mortality is a newsworthy topic right now in our country. While globally, maternal deaths are decreasing thanks to improvements in infection prevention and other precautions, in the United States, maternal deaths are actually increasing.
The increase in maternal deaths in our country is predominantly due to obesity, older maternal age at childbearing, multiple gestations (twins, triplets, etc.), and underlying chronic illnesses, such as chronic hypertension and diabetes, and inconsistent access to reproductive health services.
According to the World Health Organization in 2015, an estimated 1,200 women in this country suffered fatal complications during pregnancy or childbirth and 60,000 suffered complications that were near-fatal.
Why would a pregnant woman in this day and age need to worry about mortality during labor? The main reason is that there is an increase in American pregnant women with high-risk status. The risks are due to comorbidities, especially:
- Obesity, multiple gestations, and older age of the mother. These problems make it more likely for a woman to have or develop other medical problems during pregnancy, such as high blood pressure, heart disease and diabetes. These factors also increase a woman’s likelihood of needing a cesarean section for delivery. Being older and being obese increase a woman’s risk of complications during a cesarean section surgery.
- Hypertension and heart disease. Having hypertension or heart disease puts women at risk for developing dangerously high blood pressure or preeclampsia, which could cause a heart attack, stroke, or permanent damage to other organs, including kidneys.
- Diabetes. If not well controlled, diabetes can put a woman’s baby at risk for getting too large and increasing the likelihood of needing a cesarean section. Diabetes also makes it more difficult for women to heal from surgery and increases their risk of a dangerous infection. Pregnancy can worsen the control of diabetes and lead to very low blood sugars that can cause coma or death. (Very high blood sugars also can cause permanent damage to a woman’s heart and kidneys.)
Hypertension, heart disease, older age, obesity, and diabetes all increase a woman’s risk of developing rapid heart failure in pregnancy, called peripartum cardiomyopathy, which can be extremely dangerous and life threatening.
Here are some tips for pregnant women to increase their chances of surviving labor:
- Make a pre-conception appointment with your obstetrician if you are thinking about getting pregnant to allow you and your provider to identify risk factors specific to you and optimize your health prior to becoming pregnant. This would include optimizing your weight and getting control of your diabetes, heart disease, and high blood pressure with medications that are safe to take in pregnancy.
- Follow all of your doctor’s instructions for appointments, medications, diet, activity level, and delivery recommendations during your pregnancy. Make sure to keep all appointments and get all recommended testing in a timely fashion.
If you have any questions about your health during pregnancy, talk to your doctor. For more information about pregnancy and women’s health, visit our website at MountainVistaOBGYNmidwifery.com. Or make an appointment with me by calling (303) 744-3477 or scheduling online.