maternal mortality

Mamas on Bedrest: Pregnancy Can “Break” a Mama’s Heart!

April 13th, 2017

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 info@mamasonbedrest.com

References

Medscape

Maternal Cardiovascular Mortality in Illinois, 2002-2011

Briller, Joan MD; Koch, Abigail R. MA; Geller, Stacie E. PhD
doi: 10.1097/AOG.0000000000001981
Original Research: PDF Only

Mamas on Bedrest: The Myth of the Missing Black Father Debunked

May 19th, 2015

Greetings Mamas!!

Seldom do I revert to childish gloating, but occasionally I just have to go there. Such is the case as I am gleefully reading the report put out by the US Centers for Disease Control and Prevention utilizing data from the National Center for Health Statistics which shows that Black fathers are just as engaged-if not more so-in the rearing and support of their children than fathers of other races. 

Excuse me while I take a moment to gloat.

Yeeeeeeeee haw!!!!!

Yaaaaaaaahoooooo!!!

“Ha! Told yaaaaaaa!!”

“Na na na na na, you were wrong!!!!!”

Now you may be wondering why I am so over the moon about this research? Well, there are several reasons.

1. I am sick to death of hearing how black men are no good, they “hit it and quit it” and don’t take responsibility for the children that they help create.

2. I am sick and tired of hearing that all the ills of the world are because of black men.

3. I am thoroughly done with the portrayal of black men-black people actually-as uncivilized and bringing down the status of US culture globally.

4. And I am beyond through with this nation feeling that it is okay to kill a black male simply because he is present in time and space!

Now you all may be wondering, “What in God’s name does any of this have to do with high risk pregnancy and bed rest??” Well, it has everything to do with it. As I have often reported, African American women and infants have the worst birth outcomes of any other race or ethnicity in the US, with 2-4 times the morbidity and mortality of women and infants of other races and ethnicities. An African American infant is more than twice as likely to die before its first birthday than infants of other races and ethnicities and this is due primarily to preterm birth!!!

Are you following me yet?

Let me continue. Ever since I can remember and at least for my adult professional life “the party line” regarding the black family has been,

“It’s the breakdown of the black family, and the absence of black fathers in particular, that is the cause of the high maternal and infant morbidity and mortality that exists amongst African Americans.”

As an African American, and now as a divorced single mama, I knew that isn’t at all the case but had no way of substantiating what I knew to be true. Now there is concrete data obtained by one of the most reputable scientific bodies in the United States that has shown what many of us African Americans already knew. Yes, many more African American children are born to  and/or raised by “single” mothers, but what this study has shown is that while the parents of a child may not be married, they may in fact be together (co-habitating) and even if they are not living together, African American fathers are intricately involved in the rearing of and support (and here I do mean financially) of their children, in many cases more than White or Latino fathers.

IMG_0200

My son and his dad reading at the library.

 

So again you may be asking, “What does this have to do with preterm labor and infant mortality?” Stay with me.

There is a lot going on in the United States as regards race and quite frankly none of it is good. We have all seen and heard the news reports of police shooting unarmed African American men, racial profiling of both African American men and women, disparities in discipline for African American School Children and so on and so on and so on. These are daily facts of life, daily stressors for African American women, and daily stressors for the infants they are carrying. Additionally, poverty for all families is reaching heights not seen since the great depression and other times in our history. The unemployment rate is still teetering on the high side and looms highest amongst African American men. More depressing is the fact that people of any race with higher educations are now just as likely as those with little to no education to endure a prolonged time of unemployment, and those numbers are again higher for African American men. This amounts to markedly elevated stress for African American men and African American women, their partners. Stress, as well as poverty, is not good for anyone, but particularly not good for pregnant African American women and the infants that they are carrying. We know that stress is an independent risk factor for preterm labor, prematurity and low birth weight all areas in which African Americans have the highest rates. So I think that it is safe to say that poverty, unemployment and racism are far strong predictors and stressors on maternal and infant morbidity and mortality in African Americans than “absentee dads”.

Now I know that many of you are going to come right back at me and say, “But what about black on black violence? What about the crime rates in predominantly black neighborhoods? And we know that many African American men abandon their family responsibilities.” Agreed. But the data from this study, which was broad and the study well constructed, shows that despite all these negative influences, African American men continue to be hands on fathers, and at greater rates than white or Latino fathers.

I wholeheartedly admit that there is much that needs to be done within my culture to heal it. But let’s not look astray too much to lay blame. Much of what we see in these urban, depressed areas is poverty; boarded up buildings, non-existent stores and services, poorer schools and no revenue coming into these areas. Add to that no jobs, no way for people in these areas to support themselves and their families, no money, leads to crime and yes, homicides. Is it okay? No. Is it an excuse? Of course not. But let’s consider the fact that if people in these areas had jobs, income and ways in which to support and sustain their families, then, according to data from the CDC again, crime rates would in fact go down and quality of life would go up.

But I myself have veered a bit off topic. The bottom line is this-even in depressed economic times, even in economically depressed communities, even when jobless, even with the threats to their lives black men are taking care of their children. Contrary to the sensationalized news reports and the stereotypic depictions on television and in movies, black men are taking care of their children-their families. The question now becomes, how can we as a culture, as a nation give them a hand so that this can continue? What are we as a nation, as a culture doing to reduce poverty, increase jobs, increase opportunities for education so that not just black men, but all men, can have the means to raise and support their children?

Finally, we have to ask the question, “Have we too narrowly defined “family”? We know from this work that there are men and women living together and raising their children but not married, or married and helping to raise their spouse’s children. Aren’t they still a family? What about blended families? Large extended families? This is all data that is yet to be analyzed-or even obtained. We know that African Americans being of the African diaspora are a “tribal” people. Migration and dispersion-both voluntary and involuntary-has also played a role in the depressed socioeconomic status of African Americans resulting in decreased community support for families. How are we as African Americans going to re-establish our communities and our families going forward?

There are many unanswered questions and I am sure that many more studies will come about, but what we do know is this: African American men are supporting their children and its time to toss out the stereotypes of them as “absentee fathers” and do what we can to support their efforts and the efforts of all men who want to be active parents to their children.

References:

Jo Jones, Ph.D., and William D. Mosher, Ph.D., “Father’s Involvement With Their Children: United States, 2006–2010”. National Health Statistics Report, Number 71, December 20, 2013

The Causes of Infant Mortality-The US Centers for Disease Control and Prevention

African-American Women and Their Babies at a Higher Risk for Pregnancy and Birth ComplicationsThe US Centers for Disease Control and Prevention

Black Unemployment Rate 2015: In Better Economy, African-Americans See Minimal GainsInternational Business Times.

Murry, V. M., Brown, P. A., Brody, G. H., Cutrona, C. E. and Simons, R. L. (2001), “Racial Discrimination as a Moderator of the Links Among Stress, Maternal Psychological Functioning, and Family Relationships.” Journal of Marriage and Family, 63: 915–926. doi: 10.1111/j.1741-3737.2001.00915. x

The Absent Black Father Myth Debunked-by CDCThe Daily Kos

Mamas on Bedrest: A Step Closer to “Curing” Pre-Eclampsia!

October 20th, 2014

IMG_3750 1x13Mamas, Exciting News!!

Researchers at the Center for Perinatal Research at the Nationwide Children’s Hospital in Ohio have identified a Urine test that detects proteins in pregnant mamas’ urine that indicate pre-eclampsia. Pre-Eclampsia is one of the most common reasons mamas are prescribed bed rest, and one of the leading causes of preterm labor, prematurity and even death in mamas globally. This new finding is significant because this current research shows that pre-eclampsia, more specifically the proteins found in the urine of pregnant women with pre-eclampsia, are also associated with diseases of neurodegenerative diseases of aging such as Parkinson’s Disease, Mad Cow Disease and Alzheimers Disease.

Dr. Irina Buhimschi, director of the Center for Perinatal Research at Nationwide Children’s Hospital in Ohio and lead author of the paper. While Dr. Buhimschi admits that this is definitely a huge breakthrough in pre-eclampsia research, she admits that physicians and researchers are still no closer to knowing why some women develop pre-eclampsia and why others don’t. Pre-eclampsia is still responsible for some 75,000 deaths annually, mostly in poorer, developing nations. The proteins noted in mamas’ urine are now easily identified with a simple and inexpensive urine test called the Congo Red Dot Test. This simple test merely requires that clinicians place a small amount of urine on a test paper and if a large red dot develops, they know that the urine contains proteins indicative of pre-eclampsia.While we have reported on the Congo Red Dot test previously, a simple test like the Congo Red Dot test could really be a breakthough in treatment in these areas and significantly lower maternal mortality.

Brenda Torigiani's feet at 7 months.Pre-Eclampsia is diagnosed when a mama has high blood pressure and protein in the urine. Mamas will also often experience facial and extremity swelling. Left untreated, pre-eclampsia leads to dizziness, visual changes, seizures, stroke, swelling and weight gain, organ (kidney) failure and death. Pre-Eclampsia is a leading cause of preterm delivery, yet once the baby and placenta are delivered, mama’s symptoms resolve.

The connection between pre-eclampsia and other neurodegenerative diseases such as Alzheimers has yet to be determined. Additionally, no one yet knows if women who develop pre-eclampsia are at greater risk for developing Alzheimers or Parkinson’s Diseases or have some sort of protection. These questions will definitely have to be answered in subsequent research. In the meantime, having a low technology, easy to perform and inexpensive test to screen for pre-eclampsia may well reduce the maternal mortality associated with it tremendously worldwide. Even here in the US, this low lost, low tech test, performed early, may enable obstetricians to begin treating women early with antihypertensive medications and ward off the more serious signs and symptoms of pre-eclampsia. The next step-or perhaps leap-is that perhaps them mamas who have pre-eclampsia may not need to be placed on bed rest-so long as their blood pressures are stabilized on medications, they are no longer spilling proteins into their urine and they are not having any signs of seizure, stroke or organ failure. Finally, combining these findings with the Pluristem Technology, and yes, we may in fact be on the way to eradicating pre-eclampsia!!

Reference: MacLean’s Digital Magazine

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