NC ranks low in maternal and child health, but the crisis is widespread

Tomeka Isaac and her husband have been trying to have a baby for two years. The Denver, North Carolina resident was 40 when she conceived and was at high risk of developing preeclampsia, a pregnancy-related condition that causes high blood pressure. She took the baby aspirin recommended by her doctor and tried to do everything right.

“We went to every date, did just about everything,” Isaac said. “I took prenatals, I took an iron, I took a low dose of aspirin and everything.

But two weeks before the due date, Isaac fell seriously ill. She was rushed to the emergency room, where a CT scan was performed.

“They looked at us and they said, ‘Your son died in utero,’ she said. “I mean point blank, period. No empathy. And they say, ‘Well, you’re sick too, you’ve got HELLP syndrome.’ “

HELLP syndrome is a serious but treatable condition related to pregnancy that affects the blood and liver. Isaac says she sat in the ER for five hours before she was told she was bleeding inside. At that time, she had to be transported to the operating room. There were six more surgeries in the next 45 days.

American women are less likely to survive a pregnancy than women in other developed countries, according to The data compiled by an international organization of 37 free market countries. The United States also leads in infant mortality, which is not surprising since this is linked to maternal deaths.

North Carolina ranks 39th nationwide in infant mortality, according to the Commonwealth Fund, and the March of Dimess gives the state a D-plus for maternal and child health.

So why are the United States and North Carolina doing so badly? It is complicated.

We are the only high income country without universal health Insurance. This means that many American women are in poor health before conceiving and cannot be treated for conditions that develop during pregnancy.

Take hypertension, said Dr. Carolyn Harraway-Smith. She is the co-chair of the North Carolina Institute of Medicine Maternal Health Working Group.

“It is the # 1 cause of increased morbidity and mortality,” said Harraway-Smith. “So if a mother has high blood pressure to start with, she is more likely to have her fetus growing properly. She is more likely to have a stroke during pregnancy. So this is just a warning sign of other issues that might arise. “

Other developed countries are also focusing more on preventive and primary care. And Harraway-Smith says US needs to tackle social factors that affect health

“It’s not as simple as, ‘Go to the doctor, get your prenatal care and you’ll be fine,’ she said. “There are other problems that escape this. Housing: So does the person have suitable housing? Food: Do they have food insecurities? Education: Do they understand what they are told when they go to the doctor? “

Commonwealth Fund data shows that many high-income countries are more likely to provide care and support not just during pregnancy but in the weeks and months after birth. This is important because most pregnancy-related deaths occur after childbirth – some up to a year later.

But in most states, including North Carolina, Medicaid coverage for pregnant women ends six weeks after birth, and maternity leave is often short in the United States.

Then there is the question of race. The data from the Centers for Disease Control and Prevention shows that African American women and babies are two to three times more likely to die than white women and their infants, and that the disparity persists despite …

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