In the past decade, the United States has seen a shocking spike in the number of maternal deaths during, and after, pregnancy.
The United Nations Millennium Development Goal to achieve a 75 percent reduction in maternal mortality by 2015 was successful in many other countries, yet the United States has witnessed a rapidly rising rate. Between 1990 and 2013, the U.S. maternal mortality rate more than doubled, making the United States one of only a handful of countries to not experience a decrease.
While the number of maternal deaths is measurable, the overall cause of the increase is less clear. Researchers across the country have hypothesized about the complications that can lead to maternal mortality, generally finding an entanglement of many factors. Some reports highlight the lack of accessible, quality treatment for many women; others note the rise in cesarean sections could be to blame. But one of the most frequently cited causes of maternal mortality is chronic illness: hypertension, diabetes, and obesity often is related to high risk of death during pregnancy.
There is a high prevalence of obesity and diabetes in the United States, but both conditions are preventable and treatable. So, what can — and should — be done to help women navigate these chronic diseases while pregnant? Boston Medical Center (BMC), a member of America’s Essential Hospitals, is tackling this problem through its Diabetes and Pregnancy Program, which assists women who had diabetes before becoming pregnant.
Aviva Lee-Parritz, MD, chief of BMC’s department of obstetrics and gynecology, began the program about 14 years ago. The program comprises preconception counseling, general teaching and assistance throughout pregnancy, and medication to help manage the condition when necessary. BMC also is planning to create a group gestational-prenatal care class, specifically for women struggling with diabetes.
More proactive treatment programs, like the one at BMC, could lead to lower rates of maternal mortality. Lee-Parritz says that no deaths due to maternal mortality have been reported at BMC in the past year, and she hopes this program can serve as a model for other hospitals.