By Barbara Pierce
Pregnancy, giving birth and the first year of motherhood should be a safe and supportive experience for birthing people.
For most birthing people, pregnancy, birth and the first year proceed without concern, sometimes there are complications that require medical attention for the safety of mother and baby.
In Central New York, we have a higher rate of these complications than the national average, said registered nurse Joan Gallimo, perinatal education specialist, Mohawk Valley Perinatal Network.
The Perinatal Network is a nonprofit organization dedicated to improving birth outcomes and child and family health, under The Neighborhood Center.
“Complications do happen. We need to be aware,” said Gallimo. “Maternal mortality remains the most serious complication of pregnancy and postpartum health. In Central New York, the maternal mortality rate is approximately 22 deaths per 100,000 live births, higher than the national average.”
According to the CDC, the overall maternal mortality rate in the U.S. is approximately 17.9 deaths per 100,000 live births. The U.S. continues to have the highest maternal death rate among high-income nations.
“There is a racial disparity,” Gallimo said. “The likelihood of complications are three to five times greater for women of color and minorities.”
The incidence of complications is significantly increasing in recent years, says the New York State Department of Health online. As many as 76% of pregnancy–related deaths are preventable.
The leading causes include hemorrhage, embolism and mental health conditions, with significant racial disparities, according to Gallimo and registered nurse Michelle Firlit, community health worker supervisor for the Perinatal Network.
Gallimo and Firlit identified specific conditions to watch for, warning signs of potential complications, as they can escalate rapidly without treatment. If you experience any of the following during pregnancy or up to year after delivery, call your health care provider or go to the emergency room:
• Preeclampsia: Symptoms to watch for include sudden weight gain over a few days, shoulder pain, belly pain especially in the upper right side, severe headaches, changes in mental state, urinating less, dizziness, trouble breathing, severe vomiting and nausea, vision changes like flashing lights, floaters or blurry vision
• Gestational Diabetes: Symptoms include excessive thirst, frequent urination, feeling unusually tired or persistent dry mouth.
• Urinary Tract Infection: UTIs are common in pregnancy but do need to be treated. If any of the following happen, call your health care provider or go to the emergency room: painful urination, urgent need to urinate, foul-smelling urine, stomach pain, nausea or vomiting, blood in urine, fever of 100.4F or higher.
• Preterm Labor: Symptoms occurring before 37 weeks: Contractions every 10 minutes or more often, low back ache, belly cramps, vaginal spotting or bleeding, gush or trickle of fluid, watery, bloody or mucus-like discharge.
Post partum depression can escalate into something more serious. Postpartum depression may be mistaken for baby blues at first — but the symptoms are more intense and last longer. Symptoms include depressed mood, crying much of the time, withdrawal from others, inability to sleep or sleeping too much, overwhelming tiredness, thoughts about harming yourself or your baby.
Gallimo and Firlit offer these tips to lower your risk through pregnancy and the first year:
Attend all prenatal and postpartum visits to detect complications early. While severe conditions can be serious, many common issues are highly manageable with proper prenatal care. Your first prenatal visit should be scheduled as soon as you find out that you are pregnant or around four to eight weeks after your last menstrual period.
Postpartum visits are important, with a follow-up appointment no later than 12 weeks after birth. “Many people think, once they give birth, that’s it,” said Gallimo. “But more things can happen during the first year. A study found that postpartum visits keep people healthy from start to end.”
Continue monitoring your health throughout the entire first year after giving birth, as postpartum symptoms can emerge or persist well beyond the initial postpartum period.
“Your concerns don’t end when you push the baby out,” she said. “So many things are preventable; we want to reduce these bad outcomes.”
Know your body; speak up when something feels wrong.
“If something doesn’t seem right, it may not be,” said Firlit. “Know your body. If you have any significant changes, seek medical help immediately.”
Lean on family, partners and your wider network throughout pregnancy and postpartum so you feel heard, supported and safe. So many things can happen during pregnancy and after birth.
One more thing of interest: “We are now using the term ‘birthing person,’ rather than ‘woman,’” said Gallimo.
Getting regular prenatal care, attending all your appointments and tests and sharing your symptoms with your provider is the best thing you can do during pregnancy. Early detection and prompt treatment can help most pregnancy complications and those following the birth.