Preconception care crucial to healthy pregnancies

Date: 12/13/2010

By Richard N. Waldman, MD

President, The American Congress of Obstetricians and Gynecologists

No woman should die as a result of being pregnant. Yet each day in the US, one to two women die from complications related to pregnancy and childbirth. The rate of maternal mortality — deaths in women within a year of the end of a pregnancy from a cause related to or made worse by pregnancy — is too high in the US. And the situation may be even worse than estimates suggest because some deaths are not reported as related to gestation.

For many years, medical advances, safer deliveries in hospitals, higher standards of living, improved environmental and living conditions, a lower national birth rate, and an increased focus on prenatal care helped steadily reduce maternal death. But recently, maternal mortality has been on the rise.

The leading causes of pregnancy-related deaths are hemorrhage, blood clots, high blood pressure, infection, stroke, amniotic fluid in the bloodstream and heart disease. Some factors that may contribute to maternal mortality include more women getting pregnant later in life and more starting pregnancy with preexisting medical conditions such as diabetes and obesity. Black women also experience a significantly higher number of pregnancy-related deaths than white or Hispanic women a disparity which needs more study and has yet to be explained.

Maintaining a healthy lifestyle before becoming pregnant and finding appropriate prenatal care are integral elements in lowering the risk of dangerous complications.

In fact, as many as half of the annual maternal deaths could be prevented if women had better access to health care, received more quality care, and improved their health and lifestyle habits.

The American College of Obstetricians and Gynecologists encourages all reproductive-age women to meet with their doctors before pregnancy to discuss preconception care.

This allows your doctor adequate time to review personal health information that could affect a future pregnancy and treat any preexisting medical conditions that you may have such as high blood pressure, seizures, heart disease and substance abuse problems.

If you are pregnant, it is imperative that you visit your doctor on a regular basis and the sooner you start, the better. Prenatal visits allow your doctor to closely watch your health and your baby's progress while providing you with any special care you may need during your pregnancy.

If you are uninsured and don't have regular access to a doctor, there are programs in every state that provide low- or no-cost medical and dental insurance coverage for children and pregnant women. You can visit insurekidsnow.gov/ma/index.html.

Nonpregnant women can find free or low-cost health care clinics by state at http://findahealthcenter.hrsa.gov/.