Need to Know About Maternal Deaths Related to High Blood Pressure

Decreasing Maternal Deaths

The birth of a baby is a momentous occasion baked with excitement, sprinkled with pain, and topped with the unknown. However, most females experience anxiety and fear surrounding the birthing process. Rightfully so! Circulating around social media platforms and various news outlets are concerning information highlighting American maternal deaths. Basically, mothers are dying due to complications after the delivery of a baby at alarming rates. Why isn’t decreasing maternal deaths a priority? Consequently, we are not able to turn a blind eye to this matter any longer. Let’s educate ourselves and take the health of our loved ones into our own hands.

**Alarming Statistic Alert **

• The US has the highest maternal death rate among the world’s developed nations
• 700 women die per year, in America, from childbirth
• 50,000 women experience severe birthing complications
• ½ of the deaths could have been prevented

Listed above are only a few of the many alarming statistics printed in a USA today article by Laura Ungar and Allison Young addressing how to save new mothers’ lives. Not to mention, the state of Georgia, where I currently reside, is ranked #2 for the highest maternal deaths. As a matter of fact, this is scary! In addition, women of color are 3 to 4 times more likely than white women to die due to pregnancy-related complications according to an article by NBC News Today.

Traditionally, the mothers’ education, socio-economic status, weight gain during pregnancy, lack of prenatal care, and other lifestyle plus societal ills are blamed. In fact, these factors play only a minor role in maternal deaths. Through research and observing other countries, we are learning that there are TWO leading preventable causes of maternal mortality:

1. HYPERTENSION – dangerously high blood pressure
2. HEMORRHAGE – extreme blood loss

What Do We Know about Decreasing Maternal Deaths?

Before we explore potential solutions, we need to better understand what information is currently known. Let’s look at how the state of California was able to decrease maternal deaths and complications during delivery. In 1999, California experienced 8 deaths per 100,000 live births. However, in 2006, it increased to 16.9 deaths per 100,000 live births. The death rate basically doubled from 1999 to 2006 despite advances in medicine. In the hope that California would be able to understand the increase in maternal deaths, healthcare providers, advocacy groups, and health departments started searching for a cause and a solution. Based on their research, they developed a toolkit with clear intervention and prevention guidelines to save mothers’ lives.

The main focus was on early detection and management of high blood pressure and excessive bleeding. Since 2008, California has experienced an impressive decline in maternal mortality to a low of 7.3 deaths per 100,000. At the present time, the rest of the nation’s mortality rate is 3 times as high as California’s and continues to increase.

The main question is, WHY ARE MORE STATES NOT ADOPTING THIS TOOLKIT? Shouldn’t every clinician and facility involved in childbirth receive training regarding these updates to decrease maternal mortality rates???

What Can I Do?

The USA Today article developed a simple and practice document to safeguard mothers from preventable complications: Lifesaving Tips for a Safer Birth:

• Pay attention to blood pressure readings before, during, and up to 3 months post birth

Blood Pressure Explained

Blood pressure is a measurement of the pressure or forces the blood is pushing against the wall of your arteries. An analogy to consider is a garden water hose. When you turn on a water hose, the distance the water travels tells you how much water pressure there is. If you squeeze the water hose, the water comes out faster or with greater pressure. Blood pressure is very similar to a garden water hose; in other words, the pressure of blood against the arteries determines your blood pressure.

First thing to remember is that blood pressure is recorded as two numbers – systolic pressure over the diastolic pressure. Systolic (the top number) measures the pressure of blood in the arteries as the heart beats. Diastolic (the bottom number) measures the pressure of blood in the arteries as the heart relaxes between beats. If you have high blood pressure, it is termed hypertension whereas low blood pressure is termed hypotension.

During pregnancy, it is not uncommon for your blood pressure to decrease. Your blood vessels dilate or become larger due to the increased need to move blood throughout your body to nurture your baby.

Tips to Measure Blood Pressure Correctly

Blood pressure is very sensitive to activity and stimulating foods/beverages. Therefore, there are a few things to consider to ensure that your blood pressure measurement is correct:

• Don’t drink a caffeinated beverage or smoke 30 minutes before blood pressure is measured
• Sit quietly for five minutes before your blood pressure is measured
• During the measurement, sit in a chair with your feet on the floor or they should be supported if in a hospital bed, and your arm supported at heart level
• Feet and legs should not be crossed during blood pressure measurement
• Don’t talk or move during the measurement
• There are different sizes of blood pressure cuffs (the cuff should encircle 80 percent or more of your arm)

Why is Pregnancy Related High Blood Pressure an Issue?

Hypertension (elevated blood pressure) can present before pregnancy and in other cases, it develops during pregnancy. During pregnancy, high blood pressure is a problem for several reasons, according to the Mayo Clinic:

• Elevated blood pressure can consequently lead to a decrease in blood flow to the baby
• A decrease in blood flow to the baby can lead to problems with growth and development of the baby
• The increased pressure can damage other organs and result in injury
• Increase the risk of the placenta separating from the uterus (placenta abruption) in effect leading to heavy and sometimes life-threatening bleeding
• Increases the risk for early or premature delivery
• Increases risk for future heart and blood vessel problems

Your doctor will monitor your blood pressure and determine the best and safest solution if your blood pressure is elevated.

What Can I Do About Pregnancy Related High Blood Pressure?

1 – Understand your risk factors and discuss them with your doctor.

Risk factors include having high blood pressure prior to pregnancy, obesity, pregnancy with more than one baby, African American, prior chronic disease diagnosis (diabetes), and family history of elevated blood pressure in pregnancy.

2- Recognize common symptoms of high blood pressure.

• Protein in your urine
• Severe headaches or headaches that won’t go away
• Changes in vision (blurry or seeing spots)
• Swelling in your face and hands
• Upper right abdominal pain
• Trouble breathing

3- Ensure and insist that the medical staff is measuring your blood pressure correctly

4- Monitor and record your blood pressure during pregnancy, delivery, and up to 3 months after delivery

• During pregnancy or after delivery, systolic blood pressure (top number) is 140 or higher, or diastolic blood pressure (bottom number) is 90 or higher, maybe a signal that preeclampsia or elevated blood pressure is developing. YES, you can develop preeclampsia after you deliver your baby.
• Systolic blood pressure (top number) 160 or higher, or diastolic blood pressure (bottom number) 110 or higher, in short, you need urgent treatment.
• If your blood pressure is elevated directly after delivery and does not decrease within 15 minutes, your doctor should be alerted.
• Pregnant mother’s can purchase a blood pressure cuff and track their blood pressure daily. There are several free applications on smartphones or using pencil and paper to track your blood pressure. If you notice high blood pressure or symptoms of high blood pressure, you should seek medical attention.

In summary, the goal is to quickly identify and decrease elevated blood pressure, usually through medications. If the blood pressure remains high, the mother could suffer a stroke (blood supply to a portion of your brain is interrupted).

Let’s PAY ATTENTION and educate your support network. If you notice something weird, feel different, or are unsure, SPEAK UP and ADVOCATE FOR YOURSELF!