Pregnancy, while one of the most joyous times in a woman’s life, is also one of the most physically and physiologically stressful times. There is no doubt in anyone’s mind that pregnancy fundamentally changes a woman’s body; some women will gain as much as half of their pre-pregnancy weight during their pregnancies. Others will develop gestational diabetes, pregnancy induced hypertension or, in more severe cases peripartum cardiomyopathy (enlargement of the heart) or kidney failure. During pregnancy, the body increases its blood volume by 50 to better be able to nourish the growing fetus and maintain mama. Most women will “sail” through their pregnancies, labors and deliveries, have healthy children and will “live happily ever after”. Others won’t be so lucky and they or their children will perish from primarily preventable forms of heart disease.
Cardiovascular (heart) disease is a leading cause of death in the United States. A recent article published in Obstetrics and Gynecology reports that researchers in Illinois found that from 2000-2011, nearly 20% of all maternal deaths were heart related, Here is what they found:
- Most of the deaths occurred in the third trimester or within 6 weeks of the post partum period.
- Most of the heart related problems happened in women ages 30-39, while the most severe cases occurred in women over 40.
- Cardiomyopathy (enlarged heart)in pregnancy is a rare cardiac occurrence, is almost exclusively caused by pregnancy and occurs more often in young women, 20-29 years.
- Death from cardiomyopathy is more likely to happen in very young women, less than 20 years old.
- Black women have significantly higher rates of pregnancy related heart disease compared to White or Hispanic women.
- 28% of all of the deaths were potentially preventable.
Yes, you read that last bullet point correctly. Twenty eight percent of the cardiovascular deaths that occurred during or just after pregnancy in the Illinois report were potentially preventable deaths! So what should you, as a Mama on Bedrest do to protect her heart?
- Schedule and maintain your regular prenatal visits. Early detection and early action are the hallmarks of treatment success for any disease, but especially cardiovascular disease during pregnancy.
- Notify your health care provider immediately if you notice any heart palpitations, difficulty breathing, unusual swelling in the hands, feet, face, changes in urine output. Now this may be difficult as you are likely experiencing all of these symptoms as a result of your pregnancy. Suffice it to say that if you have an increase in any of the symptoms or if they suddenly occur where they didn’t previously exist, then consult your health care provider.
- INSIST ON FOLLOW UP AFTER YOU HAVE YOUR BABY!! One of the key points that came out of the points that came out of the Illinois study is that most of the heart disease related deaths occurred after 6 weeks post partum. Many women have their post partum follow up visits with their obstetricians and then don’t return for a year or unless there are other issues. If you had a problem, even a minor problem during your pregnancy, FOLLOW UP FOR UP TO A YEAR POST PARTUM. Many conditions will “flare” with the fluctuation of hormones during the post partum, i.e. get worse, so you want to be closely monitoring for symptoms.
It is imperative that mamas receive comprehensive care of cardiac problems and are fully treated to avoid-or at least mitigate-heart problems in the future. Thankfully not all mamas who have heart problems will die, but many will have life long problems as a result of incomplete care. Be sure to have ongoing follow up and let all subsequent providers know that you experienced heart problems while you were pregnant.
The authors also note that providers must do a better job of
- educating their patients about the signs and symptoms of cardiovascular disease
- referring patients immediately to specialists when problems occur
- continuing to monitor their patients’ conditions well into the post partum period, as long as a year post partum.
As this article clearly states, death from cardiovascular complications is very often preventable. Patients and physicians alike must be aware of the signs and symptoms of cardiovascular disease and both must have a low threshold for seeking evaluation; patients from their obstetricians, physicians from their specialists colleagues. Finally, it is imperative that women who developed cardiovascular symptoms during or just after pregnancy be evaluated for an extended time in the post partum, often up to one year post partum.
What is it like to have a pregnancy related heart problem? Hear a mamas story.
Have you experienced a heart problem during your pregnancy? Please share your story.
If you have more questions, email firstname.lastname@example.org
As Black Breastfeeding Week wraps up, I am pleased to share with you an infographic that I helped to develop. Hope it helps you have get the vital information you may need to breastfeed!!!
Black Breastfeeding Week is August 25-31, 2016. Many may be asking, if August is Breastfeeding Awareness Month and August 1-6 was World Breastfeeding Week, why is there a need for a Black Breastfeeding Week???
According to organizers Kimberly Seals Allers, Kiddada Green and Anayah Sangodele-Ayoka,
“Black Breastfeeding Week was created because for over 40 years there has been a gaping racial disparity in breastfeeding rates. The most recent CDC data show that 75% of white women have ever breastfed versus 58.9% of black women. The fact that racial disparity in initiation and an even bigger one for duration has lingered for so long is reason enough to take 7 days to focus on the issue.”
And the organizers cite 5 specific reasons a Black Breastfeeding week is essential:
- The High Black Infant Mortality Rate
- High Rates of Diet Related Disease in African Americans
- Lack of diversity in the lactation field
- Unique cultural barriers among black women
- Desert-like conditions in our communities
If you ask any black breastfeeding expert what are the top barriers to breastfeeding for black women, they will reply:
- The historical role of black women as “wet nurses” to white (slave owner’s) children
- The perception by many black people that breastfeeding is “dirty” or “nasty” (the result of #1)
- The aggressive campaign by formula companies who capitalized on the notion that “poorer women” breastfeed and modern women of means used formula.
- Hospitals that serve primarily black patients have been shown not to offer the same level of support and education for breastfeeding initiation to black women
- Few professional black lactation consultants
- The lack of support from family members for breastfeeding
It has to be recognized that breastfeeding has very different implications for black women than for white women and lactation consultants trying to counsel black women to breastfeed must be aware of the cultural history of breastfeeding for black women. They need to be aware of the fact that many black women have no breastfeeding role models as their mothers, grandmothers, sisters and aunts may not have breastfed their babies. Without the family tradition of breastfeeding, and the history of the “mammy” wet nurse, many black women lack breastfeeding support and encouragement from their families and are not eager to breastfeed themselves. Many black women work at jobs where they may not be able to take time to nurse or pump, nor do they have a private place to nurse or pump at work. For these reasons in particular and many others, it is imperative that more black women become trained as lactation consultants. Certification to become an Internationally Board Certified Lactation Consultant (IBCLC), the top credential for lactation consultants, is such a rigorous and expensive endeavor, and many black women who want to become certified state they cannot afford to undertake the process.
So while there are many challenges that face black women who choose to breastfeed and Sellers, Greene and Sangodele-Ayoka-like many other black women who are well versed in the benefits of breastfeeding for back women-have taken it upon themselves to create an organization that promotes breastfeeding and where they can provide information, education, support and resources for black women who want to breastfeed.
In counseling black women to breastfeed, highlighting the benefits of breastfeeding is a potent motivator. Breastfed babies are:
- Less likely to have allergies and asthma
- Less likely to have upper respiratory and ear infections
- Less likely to have weight problems as adults
- Less likely to develop Type 2 Diabetes
- Able to self soothe/are less fussy
- Have less stomach upset (and less incidence of Necrotizing Enterocolitis)
- May have increased intelligence
- Less likely to die from Sudden Infant Death Syndrome (SIDS)
And breastfeeding greatly benefits Mamas, Too!
- Mamas who breastfeed tend to return to their pre-pregnancy weight sooner
- Mamas who breastfeed experience decreased incidences of breast and ovarian cancers
- Mamas who breastfeed experience decreased incidences of Type 2 diabetes
Before being brought to this country as slaves, black women successfully breastfed their babies. Unfortunately, the legacy of slavery and many current socioeconomic and cultural barriers have made breastfeeding a difficult process for many mamas. It is imperative that these barriers be eliminated and that the education, support and resources be made available so that black mamas and their babies can reap the many life enhancing benefits of breastfeeding.
My Breastfed babies then…..