Is the maternal death rate actually higher? Are we just recording it more accurately? Are we including more deaths in this category than before?
The Center for Disease Control defines a pregnancy-related death as one that occurs while the woman is pregnant or within one year of pregnancy termination, regardless of the duration or site of the pregnancy. This doesn’t include any accident or other cause of death.
Age
Fifteen percent of pregnancies occur in women over 35. This number is increasing as fertility options expand and women decide to push back their date of pregnancy. Thirty percent of the 15 percent accounts for the maternal death rate.
Existing Medical Conditions
Obesity and metabolic syndrome up patient risk. High blood pressure and diabetes increase in older women who are pregnant.
Surgical Births
Cesarean sections are more prevalent. A C-section is a major abdominal surgery, increasing risk of infection and blood loss. C-sections account for 32 percent of births. This is becoming a cultural practice and is being used when not medically necessary. Vaginal birth is usually easier on cardiovascular issues than surgical birth.
Heart Disease
Cardiovascular disease is the biggest issue affecting these mothers. This includes preeclampsia, eclampsia, hypertension and heart failure developed during pregnancy. Older women, African American women and women with a hypertensive disorder are more likely to have these cardiovascular issues.
Ethnic Considerations
African American women are up to three times more likely to die in childbirth than Caucasian women. This may be influenced by access to care. The healthiest pregnancy starts before you get pregnant. Other medical problems can be addressed prior to getting pregnant to improve the future mother’s prospects.
Knowledge is Key
Educating women to know when something is wrong will help. Bleeding, sharp pain, fever, and shortness of breath may indicate a larger problem. Seeking medical attention immediately for these symptoms may help prevent some maternal deaths.
Pregnancy itself puts you at risk. Find a good doctor and a good team. Make sure your blood pressure is under control. Exercise as cleared by your doctor. Follow your doctor’s advice. Take care of yourself. Pay attention to how you feel after having the baby.
Listen in as Dr. Jenn Haythe shares how to reduce risk for maternal death.
Dr. Jennifer Haythe is a practicing Cardiologist as well as the Assistant Professor of Medicine at Columbia University Medical Center, Co-Director for the Women’s Center for Cardiovascular Health, Director of the Adult Pulmonary Hypertension Center and Director of Cardiac Obstetric Service.