Pregnancy Deaths In The US: Why CDC Believed It’s Preventable
Maternal heart disease is currently the leading cause of death among pregnant and postpartum women. By educating healthcare providers about the need to screen women early and often, this would help saves more life and reduce pregnancy death rate.
According to a new report published by the Centers for Disease Control and Prevention (CDC), about 700 U.S. women die each year from pregnancy-related complications, but about 60% of these deaths could be prevented. Women die from complications during pregnancy each year and more than half of those deaths could have been prevented.
The researchers found that about 31% of pregnancy-related deaths happen while a woman is pregnant; 36% happen at delivery or up to a week after; and 33% happen later, between one week and one year after delivery.
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Tragic Deaths Related To Pregnancy
The report analyzed data on pregnancy-related deaths in the U.S. from 2011 to 2015. A death was considered pregnancy related if the death was caused by a pregnancy-related complication, by a chain of events triggered by the pregnancy or by an underlying condition that was made worse by pregnancy.
Overall, about 3,400 pregnancy-related deaths occurred during the five-year period, at a rate of about 17 maternal deaths per 100,000 live births.
There were significant racial disparities in maternal deaths, with black and Native American women being about three times more likely to die from pregnancy-related causes, compared with white women.
Heart disease and stroke ultimately caused more than one-third of the pregnancy-related deaths overall. At the time of delivery, the most common causes of death involved obstetric emergencies, such as severe bleeding and “amniotic fluid embolism,” which happens when amniotic fluid enters the mother’s bloodstream. In the week after delivery, the most common causes of death were severe bleeding, infection and high blood pressure caused by pregnancy. Later in the postpartum period, from six weeks to one year after delivery, the most common cause of death was cardiomyopathy, or a weakened heart muscle.
“These are women in their prime who leave loved ones behind” who are often stunned by what has happened, Schuchat said. Work is needed “to make these tragic occurrences as rare as possible.
Preventing Maternal Deaths
Cardiovascular disease (CVD) is now the leading cause of death among pregnant women and women who’ve recently had a baby. Currently, approximately 1 to 4 percent of the 4 million pregnancies that occur in the United States each year are affected by CVD, according to the American College of Obstetricians and Gynecologists (ACOG).
With a timely diagnosis and a comprehensive care plan, most women with CVD can go on to have safe, successful pregnancies. However, due to the gaps and delays in properly diagnosing and treating CVD, many pregnant and postpartum women don’t receive the proper care for heart disease.
Consequently, heart disease accounts for about 26 percent of maternal deaths. But experts are hoping to change those numbers with a new plan that could save the lives of new mothers.
The report also identified a number of factors that appear to contribute to maternal deaths, as well as strategies to address these factors. For example, one issue is that some health care facilities have limited experience with obstetric emergencies, making them less prepared to deal with life-threatening complications that arise from pregnancy. To address this, hospitals could provide “simulation” training for staff members on how to deal with obstetric emergencies and implement standard protocols for responding to them.
Doctors can also help women manage chronic conditions that could contribute to pregnancy-related complications, educate their patients about the warning signs of such complications and teach them when to seek emergency care.
What Expectant Parents Should Ask Their Doctors
To find out if a hospital follows best-practice guidelines, expectant parents can look at whether the hospital has a commitment to maternal health.
“If you were looking around and you have a choice of hospitals, and there was one hospital that was really being very proactive about coming up with and addressing issues around the quality of obstetric care and care management, that would be a good thing.”
Should A Pregnant Woman Ask About Cesarean Sections During Pregnancy To Avoid Complication?
Cesarean section, also called a cesarean delivery or C-section, is medically necessary for some women. However, low-risk women who don’t need this procedure, or who elect to have one as a matter of preference, should talk to their doctors about their philosophy on cesarean first.
Cesarean section is not only a good starting point for enquiries — it can offer some women an opportunity to reduce their risks of complications. Women can ask physicians what their individual rate of cesarean section is, and whether or not they know how to perform external cephalic version — essentially a process to turn the baby if it’s breached — and delivery by forceps or vacuum. These alternative procedures can reduce the need for cesarean in some circumstances.
Though having one cesarean section raises a woman’s chances of all her subsequent pregnancies also being delivered by cesarean section.
“C-section is major surgery which brings greater complications.” “It may not be the first one that causes problems, but if you are planning on having multiple children, then it is really down the road where [the risk] starts to go up.”
Women can also ask their hospital if they do VBAC, which stands for “vaginal birth after cesarean.” However, not every hospital has the capacity to do it, being aware of these risks and asking questions can go a long way to helping women make the right choices.