July 2023

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Delivering Safer Pregnancies

Lower Your Risk of Health Problems

Pregnancy and childbirth can be a joyous time. But growing and delivering a baby are some of the most challenging things the human body can do. These processes can put so much strain on the body’s systems that they may lead to serious health problems.

Most people have healthy pregnancies. Millions of births occur each year in the U.S. But, more than 50,000 people have serious health problems during or after pregnancy. Many can be successfully treated. But some may cause life-long difficulties or even disability.

Pregnancy can trigger or uncover heart problems, high blood pressure, blood clots, or A disease in which the body has trouble controlling the level of glucose—a type of sugar—in the blood. diabetes. Some people experience severe bleeding or infection from giving birth. Others develop mental health conditions, like depression or anxiety.

The number of serious health problems and deaths from pregnancy have been rising in the U.S. in recent years. Knowing the symptoms to look out for and getting care quickly can help keep both mothers and their babies safe.

Warning Signs

The body goes through many changes during pregnancy. So women may dismiss some potentially concerning symptoms.

“But you can catch a significant number of life-threatening conditions just by listening to your body and not ignoring certain things,” says Dr. Luis Pacheco, a pregnancy expert at the University of Texas.

“If something doesn’t feel right, talk about it with your care provider,” says Dr. Janet Catov, who studies pregnancy-related health problems at the University of Pittsburgh. “The majority of severe health problems from pregnancy are preventable.”

Health problems from pregnancy and birth can happen to anyone. But some women are at higher risk than others. These include women with pre-existing health problems or who are pregnant with twins or other multiples.

Access to quality health care can play a big role in whether people stay healthy during and after pregnancy. Some parts of the country have few doctors who specialize in pregnancy and childbirth. Poverty and lack of health insurance can also affect whether people get the care they need. In part because of factors like these, Black women and American Indian/Alaska Native women in the U.S. have a higher risk of death from pregnancy-related causes than White women.

“And, pregnancies nowadays are very different from what they used to be,” Pacheco says. People have babies later in life than they used to. They’re also more likely to carry excess weight.

“These things result in a higher chance of problems like diabetes and high blood pressure in pregnancy,” Pacheco says. “But if we catch them early enough, we can provide care and control these diseases.”

“The healthier someone is entering pregnancy, the healthier their pregnancy will be,” adds Catov. “Things like good sleep and staying physically active are important for health, and for a healthy pregnancy.” So is maintaining a healthy weight and avoiding excess weight gain.

But, however healthy you are, you should still watch for certain warning signs during pregnancy (see the Wise Choices box).

Addressing Health Problems

There are effective treatments for many pregnancy-related health problems. Some drugs used for diabetes and mental health conditions can be used safely during pregnancy. Your doctor may prescribe aspirin to prevent a dangerous condition called preeclampsia if they find signs that you’re at high risk. Preeclampsia can turn into a deadly condition called eclampsia.

NIH-funded researchers are now studying whether there are benefits to treating milder health conditions during pregnancy, too.

Many women start their pregnancy with mild high blood pressure, says Dr. Alan Tita, who studies pregnancy risks at the University of Alabama at Birmingham. In the past, it often went untreated.

“We weren’t sure if treatment with blood pressure medicine would be helpful during the relatively short duration of pregnancy,” he adds.

So, in a large study, Tita and others looked at whether treating mild high blood pressure with a certain medication during pregnancy could reduce health problems. They found that it did.

“Treatment reduced the risks of problems such as preterm birth and low birth weight,” he explains. It also lowered the risks of the women’s high blood pressure getting worse during pregnancy and for severe preeclampsia.

He and others are looking at whether treating other health problems and risks during pregnancy and delivery can bring benefits, too.

Staying Healthy After Delivery

Health risks from pregnancy don’t end after delivery. Serious health problems can begin up to a year after giving birth. But the weeks right after delivery can be especially important.

“The first six weeks after pregnancy is another important time for women to pay attention to their own health. Most deaths happen in that short time after delivery,” Catov explains. “It’s a time when women are very focused on their baby. But they also need to be paying attention to how they’re feeling. Anything that doesn’t feel right, like bleeding, chronic headaches, or a chronic cough, is worth a call to the doctor.”

Catov recommends that people have a plan for emergencies in the months after birth. This could include lining up support in advance for transportation and childcare.

Prenatal care is vital for the healthiest possible pregnancy. But access to care after birth is important, too. If you’re pregnant and don’t have coverage, you can look for resources at HealthCare.gov (HHS).

Catov’s team is testing programs to improve mothers’ health in the year after birth. They’re looking for ways to manage high blood pressure from pregnancy. Women who have certain pregnancy problems, like preeclampsia and preterm delivery, are at higher risk for high blood pressure up to seven years later. “And the majority of maternal deaths happen after delivery,” Catov adds.

Catov’s team is testing a health education program for Black women who experience high blood pressure during pregnancy. Black women are much more likely than other women in the U.S to die from blood-pressure problems related to pregnancy.

Study participants get in-home training in how to measure and manage their blood pressure. The study will show if the program improves women’s blood pressure a year after giving birth.

“If we can help them get back on track for their own health, that’s going to be good for them and for their families,” Catov says.

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