Tag Archive for: MMR

How New and Expectant Mothers Can Be Healthier

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Complicated issues require complex solutions and the rise in maternal mortality rate (MMR) is complicated. Public healthcare policy and access to quality pre- and post-natal care is not directly in our hands; legislative public heath policies take time and not everyone agrees on what should be done. But a mother’s health is in her hands to some degree. What can she do to put the odds in her favor to have a healthy baby and protect her body for the long term?

Lose weight if necessary. Obesity carries with it an increased risk of high blood pressure and prediabetes. Even a 10% loss in weight may help her body withstand the stresses that pregnancy and childbirth bring. Obviously losing weight while pregnant is a delicate dance; it’s crucial to emphasize complete nutrition while minimizing calories.

Improve her fitness level. When you look at the physiological causes of MMR, close to 50% could be attributed to cardiovascular or metabolic issues such as prediabetes and hypertension. The more fit a woman is before she becomes pregnant, the lower the risk of those conditions.

Address issues during pregnancy such as gestational diabetes and preeclampsia seriously. They can impact a woman after she gives birth and contribute to increased bleeding, dangerously high blood pressure, and other cardiovascular issues. She should follow her physician’s recommendations for lifestyle and medications to address the issues.

Finally, a woman should know as much as she can about what to expect after childbirth. Not just taking care of the baby, but how to take care of her body, and the warning signs that something may not be right. When in doubt, check it out; better an unnecessary phone call than an unnecessary health crisis.

Let’s be practical. The MMR is rising but the risk is still very low at about 21 out 100,000 births in the U.S. If a woman does all she can to take care of herself before and after she gives birth, not only will it reduce the risk of MMR, it will result in healthier babies and mothers as well. That alone is worth the effort.

What are you prepared to do today?

Dr. Chet

 

References:
1. Obstetrics & Gynecology: August 2017;130(2):366–373.
2. http://bit.ly/2BZ1pOx

 

Why Is the MMR Rising?

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Based on the trends of the past 15 years, the maternal mortality rate (MMR) is increasing. There doesn’t seem to be any single cause that can be identified as “the” reason. Having looked at the research, I think there are three categories that contribute to the increase in MMR.

  • Access to prenatal and postnatal healthcare is inconsistent. In short, we don’t seem to spend enough time teaching mothers how to have a healthy baby, and then we don’t follow the mom’s health as well as we should to make sure she stays healthy. No single reason stood out, but the factors that stood out are the closing of rural hospitals, race and ethnicity, and limited access to healthcare coverage.
  • Women are waiting to have children later in life. While that’s a personal decision and can be related to the economy of the 21st century, every year older raises the risk of complications.
  • Women who wait to have children have a higher rate of obesity; along with that come a higher rate of prediabetes, hypertension, and an increased risk of cardiovascular disease.

Those seem to be the contributing factors to the increase in MMR. The question is what can be done about it? I’ll cover that on Saturday.

What are you prepared to do today?

Dr. Chet

 

References:
1. Beckers Hospital Review. December 2016.
2. America’s Health Rankings. 2016.
3. Obstetrics & Gynecology: August 2017;130(2):366–373.

 

The Rising Maternal Mortality Rate in the U.S.

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Paula recommended I read an article on maternal mortality rate (MMR). I had heard of the infant mortality rate but the MMR was new to me, so I dug into the details. This week, we’re going to take a look at the MMR, why it’s a cause for concern in the U.S., and what can be done about it.

The MMR is the number of women who die in the first year after childbirth. The problem is that there has been a rise in the U.S. MMR over the past 30 years from 7.2 women per 100,000 births to just over 26 per 100,000 births in 2015 (1). The MMR in the U.S. is moving in the wrong direction; other modern societies, such as Japan, the U.K., Finland, and Italy, have lowered their rates to fewer than five per 100,000 women. In Canada, deaths rose from six per 100,000 births in 1990 to 11 in 2013.

To use one of my favorite Vince Lombardi quotes, “What the hell is going on around here?” Why is this happening in the U.S.? The reasons are complicated, and that’s what I’ll talk about on Thursday. If you’d like to read the article that began this search for answers, check out the second reference.

What are you prepared to do today?

Dr. Chet

 

References:
1. Lancet 2016; 388: 1775–812.
2. http://n.pr/2EjqtvV