How to Have the Healthiest Pregnancy Possible

True or false: The rate of women in the U.S. who die because of complications related to pregnancy or childbirth has declined in the past 20 years.

Not only is the statement false, but the number has actually doubled over the past two decades—which is one of the reasons a panel of experts addressed the 2013 Women In the World Summit on Friday to discuss possible solutions to the global issue of maternal mortality.

“Saving Mothers: A Surprising Solution” was moderated by Deborah Roberts, a network correspondent for ABC News. The panel included Senior Chief Kwataine Masina, board chairperson of the Presidential Initiative on Maternal Health and Safe Motherhood in Malawi; Molly Melching, founder and executive director of Tostan, an organization that promotes education about women’s health in Africa; Christy Turlington Burns, founder of Every Mother Counts; and Julie L. Gerberding, MD, MPH, president of Merck Vaccines.

Maternal mortality claims about 800 women worldwide every single day, most of whom die because of post-partum hemorrhage or preeclampsia, a condition where pregnant women experience high blood pressure and protein in the urine. About 15 percent of all pregnant women have complications—and it’s how those complications are handled that makes the difference between life and death, says Burns, a former model who became passionate about the issue of maternal mortality when, nine years ago, she hemorrhaged after giving birth.

“My situation was dealt with very efficiently with a midwife and a doctor and a team of people who knew how to react,” she says. “What I learned in the weeks afterward was  that hundreds of thousands of women were dying of the same or similar complications because people didn’t know what the symptoms meant.”

One of the most poignant moments in the session occurred when Kwataine Masina, a senior chief in Malawi, recounted the story of a woman in his district who was struggling through a breech birth years ago. “We never knew what a breech was,” says Masina. “We thought she was bewitched.” After the woman had spent more than 12 hours in labor and lost a lot of blood, Masina and other local men were asked to carry the pregnant woman to the nearest hospital, which was about three kilometers away. One kilometer into the walk, the woman died in Masina’s arms. So when he took over as tribal chief in 2000, he made maternal survival a priority—a lofty goal considering that in Malawi, 1 in 36 mothers die during childbirth.

“A woman has also a right to life and a right to health,” he says. “Why should women only die like goats, die like chickens just because they want to give life?”

Masina instituted committees of women who keep track of all the pregnant women in the village and check in on them. He also recognizes men in the community who support pregnant women by taking them to a health center for prenatal visits and escorting them to a clinic for delivery. As a result, Masina hasn’t experienced a single incident of maternal mortality in his district in the past three years.

But as mentioned previously, this issue affects mothers in the U.S., as well. On the list of nations with the lowest maternal mortality rate, the U.S. actually ranks 50th, behind other countries like Bosnia, Turkey, and Kuwait. About 1,000 women a year die because of maternal mortality in this country, but another 51,000 experience what doctors call a “near miss,” where they almost die. This can often result in debilitating complications post-pregnancy, says  Priya Agrawal, MD, OBGYN, executive director of Merck for Mothers, an organization to created to save women’s lives.

The problem may be on the rise because there is no standardized quality of care from hospital to hospital, although the increased incidence of pregnant women with pre-existing conditions such as high blood pressure, obesity, and diabetes likely also contributes, says Agrawal.

Here’s what you can do to make sure you and your loved ones minimize your risk of complications—or even death—because of pregnancy:

Get adequate prenatal care
Agrawal shared the story of one woman who thought she didn’t need to visit the doctor while she was pregnant with her fourth child since, by that point, she knew what she was in for. It wasn’t until her brother encouraged her to visit the OBGYN anyway that she found out she had preeclampsia. When you manage problems effectively, you’re much more likely to avoid any lasting problems, says Agrawal.

Share your birth story—and encourage friends and family to share theirs
Often, women don’t even realize they had a near-miss until they hear others’ stories, says Agrawal, because they don’t know what’s normal and what’s not.  ”Pregnancy ends six weeks after delivery,” she says. “If you have any lingering complications afterward, you probably experienced a near miss.” If you tell your story on Merck for Mothers’ Facebook page, Merck will also make a contribution to Join My Village, an organization that supports women in India and Malawi.

Watch for warning signs
If you’re pregnant and you experience blurred vision or a headache that won’t go away, head to your doctor to get it checked out—both are symptoms of preeclampsia. Signs of a pulmonary embolism, a blood clot that’s another leading cause of maternal mortality, include severe shortness of breath and/or one leg that’s significantly more swollen, red, or painful than the other. It’s also worth noting that staying sedentary for extended periods of time—like taking a three-hour road trip—can put you at a higher risk for pulmonary embolisms (so you should stretch your legs at least once every couple of hours). As for post-delivery hemorrhaging, say something if you feel weak and you’re worried about the amount of blood you’re losing—even if no one else seems concerned. “I’d rather a woman ask me to check two or three times than walk in five minutes too late,” says Agrawal.

photo: courtesy of Women In the World

More From Women’s Health:
5 Ways Pregnancy Changes Your Body
Want a Baby Someday? How to Preserve Your Fertility
Fertility Treatments: Is IVF Dangerous?

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