Most of America's Maternal Deaths Are Preventable: Here's a Crucial Symptom to Watch Out For

I'm filing this under "articles I would've been terrified to read before I gave birth." According to this ProPublica article, "The Last Person You'd Expect to Die in Childbirth," the U.S. has the highest maternal death rate of any developing country. And the rate is going up, while in other countries it's going down. What's the problem?

"The reasons for higher maternal mortality in the U.S. are manifold," write ProPublica authors Nina Martin and Renee Montagne (also of NPR). While one of the reasons has to do with the rise in the maternal age, most of the deaths are completely preventable, and that's true of most of the other factors behind the U.S.'s scandalously high maternal death rate. The solution: We need better education and communication among both doctors and patients. That alone would have a dramatic impact on lowering the death rate.

As the authors report: "Half of pregnancies in the U.S. are unplanned, so many women don’t address chronic health issues beforehand. Greater prevalence of C-sections leads to more life-threatening complications. The fragmented health system makes it harder for new mothers, especially those without good insurance, to get the care they need. Confusion about how to recognize worrisome symptoms and treat obstetric emergencies makes caregivers more prone to error."

The devastating examples of maternal deaths in the article involve new moms in their early 30s (not older moms), and the stories of how their dangerous symptoms went unrecognized even in supposedly high-quality, top-rated hospitals are incredibly disturbing. Of the U.S.'s 700-900 annual maternal deaths (and whopping 65,000 near-deaths), 60 % are preventable, the article reports.

One important takeaway from the story and the accompanying WNYC radio interview with its authors is this: Preeclampsia, aka pregnancy-related high blood pressure, is fairly common, especially among women over 40, and it must be diagnosed and treated immediately to prevent a dangerous deterioration and potential death. That's how one of the women in the article, Lauren Bloomstein, died—and she was in her early 30s. Her preeclampsia was misdiagnosed and ignored until it was too late. Too few hospitals in the U.S. have protocols in place to deal with conditions like preeclampsia, even though those conditions are highly treatable once diagnosed. Hopefully this report will increase awareness and lead to major changes in hospital protocol.

According to the article, "By standardizing its approach, Britain has reduced preeclampsia deaths to one in a million — a total of two deaths from 2012 to 2014. In the U.S., on the other hand, preeclampsia still accounts for about 8 percent of maternal deaths — 50 to 70 women a year. Including Lauren Bloomstein." 

Efforts are already underway nationwide to address potentially fatal lapses in care: "A bipartisan bill in Congress, the Preventing Maternal Deaths Act of 2017, would authorize funding for states to establish review panels or improve their processes," according to ProPublica. Meanwhile, the health-insurance changes that the Republicans have been trying to pass could wreck those effects and worsen outcomes across the board, and especially for low-income women.

Personal note: I had sky-high blood pressure the day before I gave birth to my daughter in 2015, and I'd never before had a history of hypertension. My doctor sent me to the Labor and Delivery ward immediately after that checkup (nine days before my daughter was due). I was strapped to blood-pressure monitors and observed for four hours until the numbers went back down. Oddly enough, I tested negative for preeclampsia. But then, so did Lauren Bloomstein.