Severe pregnancy complications on the rise in Illinois, black mothers most affected

Chronic health problems are fueling a troubling spike in severe pregnancy complications in Illinois.

New research from Northern Western medicine It has been found that more patients are developing high blood pressure, gestational diabetes, mental health disorders, and obesity during pregnancy. The trend is even worse for black women and those living in poor neighborhoods.

Illinois' increase reflects national increases in obesity, high blood pressure, and gestational diabetes among pregnant women of all ages.

“Racial disparities in maternal health are nothing new,” said Dr. Mugdha Mokashi, an obstetrics and gynecology resident at Northwestern Medical School and one of the study's researchers.

“So the fact that we've known about these issues for a long time and nothing has been done to improve it is really, really concerning.”

Black women were more than twice as likely to develop serious complications compared to white women, the study found.

Northwestern researchers looked at nearly 1 million births that took place in Illinois hospitals from January 2016 to June 2023. During this period, overall severe maternal morbidity increased from 1.4% to 2%. Serious maternal morbidity refers to life-threatening complications that can occur during pregnancy, labor, and immediately after birth.

Complications during vaginal births increased by 22%, and complications during caesarean births increased by nearly 50%.

These chronic diseases can put pregnant women and their babies at risk during pregnancy and childbirth. It's all tied together, Mokashi said. Mental health issues, such as chronic stress, can increase blood pressure. High blood pressure increases the risk of diabetes during pregnancy.

And while obesity is not a perfect predictor of poor health — humans can be healthy at any weight — obesity is associated with high blood pressure and diabetes, Mokashi said.

“These are life-limiting long-term effects,” Mokashi said.

Researchers said the solution to this surge is to develop stronger policies to lift people out of poverty and improve access to health care.

“Our findings highlight the role of social determinants of health, such as race and income, in driving maternal health disparities, and efforts to reduce maternal morbidity are This suggests that both economic inequality and economic hardship need to be addressed,” said Dr. Lin Yi. is an author of the study and a physician in maternal-fetal medicine at Northwestern University.

Although more people are delaying pregnancy until late in their childbearing years, the increase in serious complications is not simply age-related, Mokashi said. Pregnant women between the ages of 20 and 29 are also affected by these chronic diseases.

Part of the problem, Mokashi said, is that not enough pregnant women in Illinois have access to prenatal care.

“There is a huge gap between what is needed and what people have access to,” she says. “We know that many people in Illinois have no prenatal care at all.”

And even fewer who are interested in having a baby receive preconception counseling, an opportunity for patients to better manage existing chronic health problems before becoming pregnant.

“Preconception counseling helps people optimize their health and make the pregnancy as safe as possible for them and their families,” Mokashi said. “But these huge disparities along racial lines are deeply influenced by structural racism and access to health care beyond the first prenatal visit.”

These findings didn't come as a surprise to doula and intake coordinator Kayla Kinsler. Chicago Birdsworks Collectivean organization that provides doula services to Black families in Chicago.

Poverty also makes it difficult for pregnant people to receive quality health care and to manage chronic diseases such as diabetes and hypertension. Eating healthy and exercising can be impossible if you live in a food desert with little green space.

“Addressing the social determinants of health will also improve maternal health care,” Kinsler said.

This study found that doula support is a step toward improving the care of pregnant people. A doula is a pregnant woman's guide from pregnancy to birth. They can help create a birth plan, answer questions, and provide emotional and physical support.

“Doulas are definitely a step toward improving the care of pregnant women,” Kinsler says. “We're there to hold their hand. We're another human being in this room advocating for them, talking with them and making sure they're an active participant in their care.” is.”