According to a study, life-threatening birth complications are more common among minorities

On Valentine's Day 2017, Ebony Boyd picked up Christmas donuts on her way to work, feeling "blessed and happy," she recalls. She was six months pregnant and excited to have a baby that she and her boyfriend had already named.

But a few hours after his work, Boyd, 36, began to feel excruciating pain. His doctor suggested he head to an emergency room at the hospital. Once there, "they checked my baby's heartbeat and there was none," Boyd said.

Boyd barely had a chance to start crying his loss when she began to have severe bleeding. His blood pressure has exploded. Two transfusions later, Boyd began to stabilize.

But by the time she was about to leave the hospital three days later, she developed a pulmonary embolism. "They said that if I had been sent home, I might not have been able to get to the next day," said sBoyd, who lives in the Bronx, at the same time. a recent interview.

Boyd could easily be one of the data points of a new study released Wednesday. She found that African-American women like her, as well as women from other minority groups, were far more likely than white women to experience serious, potentially fatal, labor-related complications.

According to the study published in Obstetrics & Gynecology, one of the factors could be the high prevalence of health problems, such as high blood pressure among women belonging to a minority, which can become dangerous when A woman is pregnant.

"It is important to identify racial and ethnic minority women with chronic conditions as a high-risk group," said Lindsay Admon, lead author of the study, assistant professor in the department of obstetrics and gynecology. University of Michigan. "The trends we are currently seeing are surprising. At the national level, they focused on the health of new mothers. "

The major problem is maternal mortality, which affects minorities even more severely than whites. Deaths are difficult to study because they are not so numerous every year. So Admon and his colleagues focused on serious life-threatening complications if they did not get the right care at the right time. The researchers estimated that by examining more than 40,000 serious complications, they could consider ways to improve the care provided to expectant mothers and reduce deaths related to childbirth.

Recent studies that have shown that death rates from pregnancy complications are on the rise have prompted some officials to take action. This week, a group of bipartisan senators sent a letter to Health Secretary Alex Azar, which said: "This disturbing trend makes the United States an exception among all developed countries."

Admon and colleagues looked at data from more than 2.5 million four-year births from 2012 to 2015, which represented a representative sample of almost 13.5 million total births in the United States. United during the same period.

The researchers found that the rate of major birth problems was 70% higher in non-Hispanic black women than in non-Hispanic white women. Compared to non-Hispanic white women, Hispanic, Asian or Pacific Islanders and Native American or Native American women in Alaska also had higher rates of serious complications.

"Recognizing that these disparities exist, it is incumbent on us to find a way to reduce these disparities," said Dr. Alan Peaceman, Chief of Maternal and Fetal Medicine at the Feinberg School of Medicine at Northwestern University and head of the Department of Medicine. obstetrics at Northwestern Memorial Hospital. "The numbers here are surprisingly high."

Women of all races and ethnicities who had a chronic health problem, such as asthma, diabetes, kidney disease or high blood pressure, before giving birth were at a higher risk of serious complications related to childbirth. The study found that black women who had two or more chronic health problems were nearly three times more likely than those who had none to have a serious birth-related complication.

According to experts, it is essential to control these chronic health problems before the woman becomes pregnant or at the beginning of pregnancy to reduce serious complications and possibly deaths.

"The authors assume that pre- and postpartum management would make a difference," said Dr. Andrew Satin, professor and director of gynecology and obstetrics at Johns Hopkins Medicine. "And I agree with that. What we really need is to give the patient optimal fitness before she gets pregnant and then manage her chronic health problems. "

Dr. Kirsten Lawrence Cleary agrees that, ideally, women should return to health before becoming pregnant. But even if doctors do not see a patient before conception, many serious complications can be avoided if chronic conditions are "assessed and managed very accurately during pregnancy and postpartum," said Cleary. assistant professor and mother. Fetal Medicine Specialist at NewYork-Presbyterian University Medical Center-Columbia.

This is Cleary's strategy with Boyd.

When Boyd learned that she was pregnant again last November, she returned to the hospital that treated her on Valentine's Day, New York-Presbyterian, who had initiated a new program focused on future moms, called the Mothers Center. The goal of the center is to treat these mothers for conditions that can make delivery dangerous, with the aim of reducing serious complications and the number of deaths.

It seems to have worked for Boyd. With her blood pressure under control, the pregnancy this time "was a smooth run," she said. "It was really, really good."

In July, Boyd gave birth to a baby girl. She and her boyfriend named her Janiyah S'Mori Darden.

Although her story has finally had a happy ending, she wants to tell it "because I do not think that many women are aware of the risks, especially the minorities," she said. "I want women to watch the signs and be comfortable getting a second opinion. Two lives are at stake, not one. "