Maternity Care and Women’s Health

Unless a person is a mother or about to become one, they might not be aware of the variety of healthy choices and precautions related to pregnancy. It is disappointing to acknowledge that factors like socio-economic status, illness, and race can determine the mortality rate of a mother and her child, especially in the United States today.

It is essential to improve the well-being and care of mothers, as they will lead by example, setting a foundation for a healthy lifestyle for the next generation.

Factors such as socio-economic backgrounds, unplanned pregnancies, inappropriate access to prenatal services, maternal age, health of the mother before and after pregnancy, along with mortality rates influenced by race, are all issues that impact maternal health. Socioeconomic factors including poverty, race, age, and income play a significant role in determining a mother's well-being. Pregnancy should be a delightful period in a woman's life, but it can turn tragic if they are not able to access proper prenatal services and support.

In the United States, over 80% of women will become pregnant, and out of these, 31% will experience complications ranging from depression to needing a C-section delivery ('Maternal, Infant, and Child Health,' Healthy People 2020', 2018). Despite modern medicine's advancements, the United States' pregnancy mortality rate is at 12.7 deaths per 100,000 live births as of 2007 ('Maternal, Infant, and Child Health,' Healthy People 2020', 2018). Pregnancy should not pose a health risk to women; instead, it should present an opportunity for mothers-to-be to identify and mitigate any existing health risks and avoid the dangers associated with inadequate pregnancy care. Some crucial health risks that can be addressed and prevented during pregnancy include heart disease, diabetes, sexually transmitted diseases, and unhealthy weight.

The rate of complications during pregnancy can vary, encompassing everything from high-risk heart disease to unplanned pregnancies. Expectant mothers with known heart diseases are at substantial risks for complications during pregnancy and delivery due to their cardiac issues. It is crucial for these women to inform their doctors about their conditions before deciding to have a baby, and they should closely monitor their pregnancy as it progresses.

The article 'The Pregnant Woman with Heart Disease: Management of Pregnancy and Delivery' mentions that 'a risk assessment should be performed in these women,' and 'the management of pregnancy and delivery should be planned accordingly' (2011). The article also mentions that it is crucial for the team of doctors to communicate accordingly to prevent complications that can place the mother in danger during delivery. Additionally, unplanned pregnancies have complications of their own. In a perfect world, a woman who finds out she is pregnant is in good health and doing financially well. However, The Office of Women's Health states that one in two pregnancies in the United States is unplanned ('Unplanned pregnancy | womenshealth.gov', 2018). Women can find themselves in situations where they are financially unstable to care for a baby, or their lifestyle choices can put the life of the infant in danger. The Office of Women's Health recommends for women who find themselves in unstable situations to ask for the help of a medical professional to confirm the pregnancy, and to take steps to quit smoking or drinking if that is part of their lifestyle.

4. Prevalence: Weight is a major determinant of women's pregnancy outcomes. Like anything related to weight, women who enter pregnancy at a high or low weight are likely to experience negative health effects during their pregnancy. Their weight may also affect their infant, who will have poor health before and after birth. Because weight affects the outcomes of pregnancy, Healthy People 2020 points out in one of their solutions for maternal health to increase the proportion of women entering pregnancy with normal weight (Sharma, 2018).

Healthy People 2020 also takes into consideration the diversity of races and ethnicities across the United States that may affect the proportion of women entering pregnancy at a healthy weight.

5. Case Fatality: Pregnancies can carry a fair share of complications, during the prenatal stages of pregnancy to having a difficult delivery. It is sad to admit, however, that race can determine if a mother gets to survive those complications during her pregnancy. The article 'The Black–White Disparity in Pregnancy-Related Mortality From 5 Conditions: Differences in Prevalence and Case-Fatality Rates' studied the case fatality of black and white women affected by 'preeclampsia, eclampsia, abruptio placentae, placenta previa, and postpartum hemorrhage' (Berg, Callaghan, Hsia, Tucker 2007). The study concluded that black women were three times more likely to die than their white counterparts if they suffered these conditions. The article also discussed that black women were less likely to partake in prenatal care during the first trimester of the pregnancy and were more susceptible to suffering from preexisting conditions. An Institute of Medicine report also discovered that minority patients receive lower quality of care compared to white people regarding their medical problems (Berg, Callaghan, Hsia, Tucker 2007).

The race of the patient is a determinant of case fatalities in pregnancies, and research is still being conducted to avoid it being an influence on pregnancy mortality rates.

Two at-risk groups include:

Women over the age of 35: Women over the age of 35 tend to have more difficult pregnancies than their younger counterparts. They are prone to conditions like high blood pressure, diabetes, or cardiovascular disease that can complicate the progress of the pregnancy. These conditions can contribute to miscarriage, poor fetal growth, and birth defects (Stickler & Seladi-Schulman, 2018).

Women with STIs (Sexually Transmitted Infections): Expectant mothers with an STI (or STD) are likely to transmit the infection to their baby. STIs pose a dangerous risk to both mother and child. The mother can expose the baby to life-threatening illnesses, such as HIV and meningitis. Moreover, STIs can complicate the mother's pregnancy. As Tracy Stickler and Jill Seladi-Schulman, Ph.D. note, untreated STIs can lead to 'miscarriage, premature birth, and low birth weight' (Stickler & Seladi-Schulman, 2018).

In both cases, doctors should closely monitor their patients to ensure that the pregnancy is not jeopardizing the health of the mother and child. Older women are prone to dealing with cardiac issues, whereas a woman with an STI has an increased likelihood of losing her baby.

Interventions include:

• Advocating for healthy weight: Doctors and expectant mothers should collaboratively devise a pregnancy meal plan that meets the mother's nutritional needs. Both underweight and overweight women run significant risks if they don't manage their weight effectively.

• Addressing unplanned pregnancies: Women who smoke and drink alcohol endanger their pregnancy, and these behaviors can lead to unusual health issues for both the infant and the mother. Providing easily accessible prenatal care for women dealing with these situations is crucial. They should be made aware of the negative effects of their lifestyle choices and encouraged to take their health seriously.

• Monitoring cardiac health: Women with cardiac illnesses require close monitoring throughout their pregnancy. Pregnancy already stresses the body, and doctors should ensure that neither the woman nor her baby are at risk.

• Offering STI screenings: If a woman suspects she is pregnant and may also have an STI, medical centers should offer screenings and assessments for both conditions. Early detection is essential and offers the best chance for effective treatment.

• Recognizing and addressing racism: Doctors must recognize the prejudices that women from different ethnic backgrounds face during their pregnancy. They should not allow race to influence their judgments about their patients' symptoms. The aim should be to support all women to have a healthy pregnancy, irrespective of their race/ethnicity.

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