Maternal Mortality: Know the Warning Signs and Act

Date: May 2, 2022

“Excellent prenatal care ensures that your pregnancy is advancing in a healthy way,”

Bringing a new life into the world is an exciting, even thrilling experience, and most women recover at home without much difficulty. But for some, the experience is much different. They develop complications before, during or after the birth of their child. Sometimes the warning signs are obvious, but often they are not. Sadly, about 700 people die each year in the United States as a result of pregnancy or delivery complications. This occurrence, called pregnancy-related maternal mortality, is a tragedy for their families and society as a whole.

At Emory Healthcare, physicians, nurse-midwives, nurses and other providers are committed to preventing such deaths. Leading the way is Rose Horton, RN, MSM, NEA-BC, specialty director of Women and Infant Services at Emory Decatur Hospital.

“A woman’s ability to reproduce and give birth is amazing, and we need to support them with the resources they need to have a healthy pregnancy, birth, and postpartum experience,” she says. “Our team at Emory Decatur Hospital’s Maternity Center has extensive training and experience to recognize early warning signs of potentially life-threatening problems. We also educate moms about what to look for after they return home.”

The Nine Post-Birth Warning Signs

Maternal mortality is more likely to happen after mom and baby leave a hospital following delivery. According to a 2021 report published by the Georgia Department of Health:

  • 19% of maternal deaths occur during pregnancy and delivery
  • 28% occur in the six-week postpartum period
  • 36% occur from seven weeks to one year postpartum

In the busy-ness of taking care of a new baby and juggling other responsibilities, it’s easy to dismiss the signs of a serious problem. At Emory Decatur Hospital, an eye-catching flyer posted in the maternity center, neonatal intensive care unit and emergency department spells out the warning signs with the acronym POST BIRTH.

The flyer tells women to call 911 if they have:

  • Pain in the chest
  • Obstructed breathing or shortness of breath
  • Seizures
  • Thoughts of hurting themselves or the baby

…and to call their health care provider if they have:

  • Bleeding concerns: Soaking through one sanitary pad in an hour or less; blood clots the size of an egg or larger
  • Incision that is not healing
  • Red or swollen leg that is painful or warm to the touch
  • Temperature of 100.4°F or higher
  • Headache that does not improve even after taking medicine, or a bad headache with vision changes

“Women need to be vigilant about their health, especially during those first six weeks after childbirth,” Horton says. “It’s so important that they know their bodies and seek care when something doesn’t seem right. If a provider isn’t taking their concerns seriously, they need to find a provider who will.”

According to the Centers for Disease Control and Prevention (CDC), Black women are five times more likely to die from maternal mortality than White women, even when factors such as education, income and zip code are factored out. Horton says it’s important for our society to ask why this is the case and that researchers are investigating the underlying causes. “What we do know is that implicit bias and racism is a contributing factor to morbidity and mortality.”

The Top Six Causes of Maternal Mortality

Complications of pregnancy and childbirth can affect people of all ages, races and backgrounds. According to a 2021 report published by the Georgia Department of Public Health, the leading causes of maternal mortality in our state are:

  • Cardiovascular conditions, such as heart attack and stroke
  • Pulmonary embolism, also known as a blood clot in an artery in the lungs
  • Cardiomyopathy, which is a disease of the heart muscle
  • Hemorrhage (heavy bleeding that typically occurs within two days of the baby’s birth)
  • Preeclampsia, which causes high blood pressure and increased protein in the urine. It can lead to seizures and affect the baby’s blood supply during pregnancy. Learn more about preeclampsia.
  • Amniotic fluid embolism. This very uncommon condition occurs when amniotic fluid in the womb enters the mother’s bloodstream and triggers a serious reaction.

The Importance of Good Prenatal Care

About 87% of maternal deaths are preventable—and prenatal care should be part of every pregnancy, Horton says. During prenatal visits, the provider looks for possible warning signs, such as:

  • High blood pressure or an elevated heart rate
  • Significant swelling in the hands and face
  • Significant weight gain
  • Poor fetal growth

“Excellent prenatal care ensures that your pregnancy is advancing in a healthy way,” Horton explains. “If your provider notices anything concerning at a prenatal appointment, you may be asked to come in for more frequent visits to monitor you and your baby carefully. Or you may receive a referral for home health care or a subspecialist, such as a heart doctor or a dietitian.”

Emory Decatur Hospital Maternity Center

Almost 4,000 Atlantans give birth at Emory Decatur Hospital every year. The hospital offers beautiful labor and delivery rooms, a Level III Neonatal Intensive Care Unit and neonatologists, anesthesiologists and obstetricians who are onsite 24/7. To learn more, visit our website or view our virtual tour and see for yourself.

Looking for an OBGYN? Visit our provider directory

Schedule your appointment today.

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