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Pregnancy-related deaths are increasing in the United States and the main risk factor is darkness, according to new reports that highlight racial disparities in care provided during and after childbirth.
Black women, as well as Native Americans and Native Americans of Alaska, are three times more likely to die before, during or after the birth of a baby, and more than half of these deaths are preventable, concludes Tuesday's report from the Centers for Disease Control and Prevention.
Although these deaths are rare – around 700 a year – they have been increasing for decades.
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"Today, an American mother is 50 percent more likely to die in childbirth than her own mother," said Dr. Neel Shah, an obstetrician at Harvard Medical School.
In addition, the American College of Obstetricians and Gynecologists has issued new guidelines stating that being black is the main risk factor for these deaths. According to the guidelines, women should have a complete assessment of heart risks 12 weeks after childbirth, but up to 40% of women do not come back for this visit and payment problems may be there. ;one of the reasons.
Bleeds and infections caused most pregnancy-related deaths, but heart problems are now.
"Pregnancy is really a stress test" because of the excess blood that the heart moves for the mother and the child, said Dr. James Martin, head of the recommendations working group. This can reveal previously unknown problems or create new ones.
The CDC report revealed that about one-third of maternal deaths occurred during pregnancy, one-third in the week following birth or less than one week after birth, the remainder up to one-third. one year later.
Globally, maternal mortality has dropped by about 44% between 1990 and 2015, according to the World Health Organization. But the United States is out of step: moms die about 17 times out of 100,000 in the United States, compared to 12 per 100,000 a quarter of a century ago.
Possible factors include high rates of caesarean section in the United States and high rates of obesity, which increase the risk of heart disease, diabetes and other complications.
In the United States, black women are about three times more likely to die of a pregnancy-related cause than others, in part because of their racial bias when they seek treatment. and the fact that doctors do not recognize risk factors such as high blood pressure, said Dr. Lisa Hollier. , the chairman of the group of obstetricians.
Stacy Ann Walker can be an example. She was 29 years old, she was healthy and she was eager to wait for her first child eight years ago "when the unimaginable happened and left us both fighting for our lives."
The woman from Hartford, Connecticut, said her doctor had dispelled her complaints of shortness of breath, tiredness and swelling of the legs, such as normal pains of pregnancy. Her baby has developed life-threatening complications, requiring emergency cesarean section, and weighing less than 3 kilos at delivery.
But his ordeal was not over. After birth, she developed heart valve problems and heart failure requiring surgery.
"I never would have thought my life would be in danger," said Walker, a black race. She spoke at a press conference of the group of obstetricians on the guidelines.
The CDC examined about 3,000 pregnancy-related deaths between 2011 and 2015, using death certificates. The researchers also examined more in-depth investigations of approximately 250 deaths in 13 states.
This latest study determined that 60% of deaths could be prevented. Often, three or four problems contributed to death, ranging from doctors' mistakes to the difficulty some women had in finding housing and healthy food.
The report shows the need to educate doctors and patients about the risks for new moms and expand Medicaid health coverage in all states so that postpartum care is available to all moms until one year after giving birth, said Dr. Alison Stuebe of the University of North Carolina.
"As a society, we do a terrible job of taking care of mothers after the baby is born," she said.
"It's as if the baby was candy and the mom was packing," she added. "Once the baby is out of the package, the package is set aside."
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