What You Need to Know
- The United States has the highest rates of maternal mortality in the developed world.
- Hypertensive disorders that start during pregnancy are responsible for 7.8% of all pregnancy-related deaths.
- Regular blood pressure monitoring could cut death rates overnight.
Remote blood pressure monitoring is a critical tool for reducing poor outcomes in high-risk pregnancies. Stakeholders across the maternal health space need to come together to provide it for all moms, regardless of the mother’s apparent level of risk.
The United States has the highest rates of maternal mortality in the developed world. Over 50% of those deaths occur in the postpartum period, and 60% of those deaths are preventable. Black women are two to three times more likely to die than their peers, regardless of income or status.
These facts are so ubiquitous that a quick Google search of any of them will bring up hundreds of hits. If we’re so aware of the issues, then why hasn’t the needle moved on outcomes?
Part of the problem is the sheer variety of causes — and they can’t be unilaterally abolished by the stroke of a pen on legislation.
We need to focus on fixing the issues that can help the most people in the shortest time, that don’t require decades of cultural and structural change to resolve.
We need to go after actionable targets, starting with preventable prenatal and postpartum deaths and the issues that can contribute to them, like hypertension.
Hypertensive disorders with onset during pregnancy are responsible for 7.8% of all pregnancy-related deaths, and that doesn’t take into consideration cardiovascular issues and other health problems to which hypertensive disorders of pregnancy (which occur in nearly 10% of all gestations) are often a precursor.
Maintaining a certain blood pressure has been proven to directly affect the risk of hypertension and improve outcomes. In some cases, elevated blood pressure is the only indication of a dangerous condition like preeclampsia. If a woman is only having her blood pressure taken at her regularly scheduled prenatal visits, it is highly possible that high blood pressure could go undetected.
During the postpartum period, the safety net is even worse — women typically do not see their doctor until a single follow-up appointment six weeks after giving birth. Many women fail to attend this appointment, and for some others, six weeks is already too late to catch life-threatening complications. A new mother who is normotensive at discharge can quickly become hypertensive, even if she experienced no blood pressure complications before or during her pregnancy.
Every pregnant woman should be on blood pressure monitoring, through and up to at least six weeks postpartum.