Authors: Marie Gibb
Mentors: Francine Jensen
Insitution: Utah Valley University
Maternal mortality, also known as maternal death, is defined as the death of a woman during pregnancy and up to one year postpartum. (MacDorman et al., 2021; Spelke & Werner, 2018). The United States is the only developed nation where the rates of maternal mortality are rising, and they have been rising for twenty years (Simpson, 2019; Spelke & Werner, 2018). This incidence represents a maternal health crisis in the United States. On average, 700 women in the United States die each year from pregnancy-related complications. This equates to 17.2 maternal deaths for every 100,000 live births (Simpson, 2019). Currently, the maternal mortality rate for Utah is higher than the national average at 21.5 maternal deaths per 100,000 live births (Utah Department of Health and Human Services, 2023). According to More than 60% of these deaths are preventable (MacDorman et al., 2021; Simpson, 2019).
The leading causes of maternal death in the United States are hemorrhage, preeclampsia, eclampsia, hypertension, embolisms, and cardiomyopathy, which often lead to cardiovascular disorders (MacDorman et al., 2021; Simpson, 2019). The Utah Health and Human Services (2023) reported that increases in heart disease, hypertension, diabetes, mental health disorders, and other chronic conditions complicate pregnancies and are contributing to maternal mortality in Utah. The American Heart Association has cautioned that pregnancy complications like preeclampsia, gestational diabetes, and preterm delivery are linked to maternal heart disease later in life (Parikh et al., 2021). Research suggests that each episode has a cumulative effect (Marill, 2021), meaning, the more pregnancies women have, and the more complications women have during pregnancy, the more elevated their risks are in general for cardiovascular disorders as they age.
A qualitative survey was sent out using snowball sampling to women over the age of 18 in Utah asking about their understanding of cardiovascular risk factors and current health conditions. Findings showed that women were unaware of their potential cardiovascular risks associated with pregnancy. Raising awareness regarding these cardiovascular risks may be the number one preventative strategy, as women are the ones who bear the personal and physical risks. If pregnant women are aware of their cardiovascular risk factors, they can be empowered to raise concerns when necessary. Future interventions may include educating all women of childbearing years about cardiovascular risks prior to pregnancy, as well as more frequent screening of women during and after delivery (Marill, 2021).
References
MacDorman, M. F., Thoma, M., Declcerq, E., & Howell, E. A. (2021). Racial and ethnic disparities in maternal mortality in the United States using enhanced vital records, 2016‒2017. American Journal of Public Health, 111(9), 1673–1681. https://doi.org/10.2105/ajph.2021.306375
Marill, M. C. (2021). Getting to the heart of America's maternal mortality crisis. Health Affairs, 40(12), 1824-1829. https://doi.org/10.1377/hlthaff.2021.01702
Parikh, N. I., Gonzalez, J. M., Anderson, C. A. M., Judd, S. E., Rexrode, K. M., Hlatky, M. A., Gunderson, E. P., Stuart, J. J., & Vaidya, D. (2021, May 4). Adverse pregnancy outcomes and cardiovascular disease risk: Unique opportunities for cardiovascular disease prevention in women: A scientific statement from the American Heart Association. Circulation, 143(18), e902-e916. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000961
Simpson, K. (2019). Maternal mortality in the United States. MCN, The American Journal of Maternal/Child Nursing, 44 (5), 249-249. doi: 10.1097/NMC.0000000000000560.
Spelke, B., & Werner, E. (2018). The fourth trimester of pregnancy: Committing to maternal health and well-being postpartum. Rhode Island Medical Journal (2013), 101(8), 30–33.
Utah Department of Health and Human Services. (2023, March 16). Complete health indicator report of maternal mortality. Retrieved Sat, 09 September 2023 from the Utah Department of Health and Human Services, Indicator-Based Information System for Public Health website: http://ibis.health.utah.gov. https://ibis.health.utah.gov/ibisph-view/indicator/complete_profile/MatMort.html