Discover more from Slow Aging and Delay Chronic Disease Development
Maternal Mortality is Three Times as High in Black Women
Three times as many black women die in childbirth compared with Hispanic and white women and their cause of death is different. In black women preeclampsia and eclampsia were the leading causes of death and heart failure was next. Blood clots and bleeding we the next most common causes. Tubal pregnancy was the fifth leading cause in black women, but infrequent in other women.
Later deaths that occur between six weeks and one year after birth are three and a half times more likely in black women. Heart failure was six times as frequent. The factors that increase the risk of heart failure with pregnancy include age over 30, high blood pressure, diabetes, obesity, selenium deficiency, zinc deficiency, and substance abuse. Black women account for forty percent of heart failure cases. The frequency of this disease varies dramatically from one country to another. One in 100 women in Nigeria have heart failure with pregnancy. In the US it is one in 1,000, and in Japan, it is one in 20,000. There is also extreme variation between states with black women having heart failure from three to sixteen times more often. The number of those impacted by this disease is increasing. Excess oxidant production and inflammation are associated with increased obesity, diabetes, and hypertension in blacks and are also involved in heart failure.
Part of this glaring disparity is related to lifestyle. American black women have the highest risk of obesity of any group in the US. Eighty percent of these women are overweight or obese and that leads to high blood pressure, diabetes, and increased risk. More weight increase the risk of preeclampsia and heart failure. That increases their pregnancy risk, but it is not their fault. Most of us are not equiped to deal with a “landscape of cheap, convenient, calorie-dense foods that have been specifically engineered to be irresistible.” I took care of patients with diabetes and high blood pressure. I weighed 307 pounds myself. Food is “engineered to be irresistible” by combining fat, salt, sugar, and carbs. It is so delicious that many of us will eat it when we are not hungry and the more we eat the more we want. Part of the answer is to change what we eat. We can reduce maternal mortality and damaged children in part by eating real food—lean meat, eggs, seafood, fruits, vegetables, beans, peas and nuts. Many black Americans live in food deserts and that makes a healthy diet much harder. We all have a stake in solving that problem.
There is a common thread here. These same factors contribute to complications in infants like prematurity, low birth weight, increased birth weight, and an increased risk for heart disease, diabetes, and cancer later in life. Mothers are older now and more likely to have hypertension and diabetes. Some of these individual hospitalizations cost over one million dollars. These increased risks are passed on to future generations. The good news is that these risks can be changed.
Most births occur without problems in the baby or the mother. Research on costs and outcomes are limited and the impacts are probably underestimated, but this is an extremely important topic because maternal and newborn complications can have an impact on the health and longevity of generations to come. These problems are also very expensive. Maternal mental health issues cost eighteen billion a year, hypertension nearly eight billion, and diabetes $4.8 billion. “We estimated total maternal morbidity costs for all U.S. births in 2019 to be $32.3 billion from conception through the child’s fifth birthday. This amounts to $8,624 in additional costs to society for each maternal–child pair.”
We could dramatically improve this terrible problem quickly. California has done it. The California Maternal Quality Collaborative uses systems, protocols, and toolkits to dramatically reduce maternal mortality and complications. Your state and community could do the same! It is not that complicated.
Slow Aging and Delay Chronic Disease Development is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.