⚠️👩‍⚕️👶🩺 Da Kine Dangers Afta Mama An’ Keiki Go Home: Changes fo’ Doctors Taking Care New Mamas” 🏠🤱

Recent research wen show us dat da mos’ pregnancy-kine deaths, dey happen within da year afta one baby born. Dis kine discovery stay changing how da doctors taking care da new mamas. 📚🔬👩‍⚕️🤰⏰🍼

Sherri Willis-Prater, her baby boy only had two months, and she was ready fo’ go back work at one school cafeteria in Chicago. But one evening, when she try walk up da short flight of stairs to her kitchen, she almost fall over, gasping fo’ breath. 🏠👶💼🏫🍎🥪🥵🥴

When dey take her go hospital, Ms. Willis-Prater, who had 42 years at dat time, got hooked up to one ventilator dat help her breathe. Da doctors wen tell her, her heart stay working less den 20 percent. She had developed one rare heart failure dat only come afta pregnancy. 💔🏥👩‍⚕️🤒💨

Dis kine diagnosis was da last ting she was expecting to hear. Afta she wen give birth, Ms. Willis-Prater t’ought, “I made it across da finish line,” No need worry about anyting anymore. 🤷‍♀️🏁😨

Mos’ peepol t’ink da labor and da birth is da mos’ dangerous part of pregnancy. But new scientific research stay challenging dis kine t’oughts, finding dat da big kine risks stay there fo’ full year afta da birth. Da mos’ deadliest time fo’ da mamas is actually afta da baby born. 🤔🤰⏰👶💀

An’ fo’ each wahine who dies, about 50 to 100 women experience severe complications dat might give dem lifelong health problems. Da numbas stay growing as mo’ American women stay becoming heavier, and tings like high blood pressure and diabetes becoming mo’ common. 📈🤰🔢🩺🍔🥤

Mo’ wahines also waiting till later in life fo’ have kids, so dey mo’ likely fo’ start pregnancy wit’ long-term medical conditions dat can lead to complications. ⏳👵🤱💊🔬🩺

Da new figures come when dea’s one troubling rise in deaths of pregnant wahines and new mamas in da United States, dat get da highest maternal mortality rate in da industrialized world. Da numbers wen go up during da pandemic, to 32.9 deaths fo’ every 100,000 live births in 2021, up from 20.1 per 100,000 in 2019. Da rates fo’ Black and Native American wahines stay two to three times higher den those fo’ white wahines. 📊🌎👩‍⚕️🤒🔝

But deez figures only show one traditional definition of maternal mortality, deaths dat happen during da pregnancy or up to six weeks afta birth. 📚🤱🏥💀⏰

One mo’ full kine understanding of da problem wen come out in September, when da Centers fo’ Disease Control and Prevention took one mo’ wide look at mamas’ deaths, analyzing dem fo’ full year afta childbirth and including deaths resulting from mental health conditions. 📅🔍💀🤱👩‍⚕️🧠💔

Based on data from 36 states on 1,018 pregnancy-related deaths from 2017 to 2019, da C.D.C. concluded dat about one-third of dem occurred during da pregnancy or on da day of delivery, and roughly another third before da baby wen turn six weeks old. Full 30 percent occurred from dat point until da baby’s first birthday, one period dat neva been one focus of maternal mortality research. 📊📝👶🤱💀🧪🔬

Da data wen lead to calls fo’ closer follow-up care and mo’ support fo’ new mamas during what dey call da “fourth trimester,” wit’ special attention given to da vulnerable wahines. 📊📞🤱👩‍⚕️🧸💖

“We need fo’ recognize dat da mamas stay getting real sick and dying,” said Dr. Alison Stuebe, one professor of obstetrics and gynecology at da University of North Carolina School of Medicine. 👩‍⚕️💬🤱😷💀🎓

Da biggest causes of maternal mortality among white and Hispanic wahines are mental health conditions dat lead to suicide or fatal overdoses. Among Asian wahines, da biggest cause is hemorrhage. Among Black wahines like Ms. Willis-Prater, heart conditions was da biggest cause of death. High blood pressure, a predisposing factor, stay more common among Black wahines, and dey often have poor access to health care, one legacy of poverty and racism. 🏥💔🧠🌎👩💊💔

Da risk of later maternal death — from six weeks to one year afta delivery — is 3.5 times higher among Black wahines, compared with dat among white wahines. 📈🤱💀⏰🔍👩🏿‍🦱👩

Medical practice often slow fo’ change. But da numbers are accelerating revisions to Medicaid, da health plan dat covers low-income Americans, including mo’ den 40 percent of pregnant wahines in da United States. 🏥📈💉🤱🇺🇸

Thirty-three states and Washington, D.C., have extended Medicaid coverage fo’ new mamas to one full year afta childbirth, so wahines stay insured while dey recovering from pregnancy, and eight other states planning to do so, according to the Kaiser Family Foundation. Three states, including Texas, are only giving limited coverage, and six — including Arkansas, dat had one of the nation’s highest maternal mortality rates — get no plans to extend Medicaid coverage, according to da foundation. 📊🗺️👶💊🏥👩‍⚕️

Odah tings dey doing include one new law in New Jersey dat requires emergency room doctors to ask wahines of childbearing age about their pregnancy history. Some illnesses dat bring wahines to da hospital might be diagnosed more quickly if doctors know dey new mamas. 🚑🏥👩‍⚕️🤰💬👶📚

In North Carolina, health providers get one $150 bonus if one patient comes in fo’ one postpartum visit. Historically, nearly half of new mamas miss their postpartum checkups. Doctors now advised to see new mamas within three weeks of childbirth, rather than wait fo’ the six-week checkup dat was one time da standard. 💸👩‍⚕️👶📆📋💖

“Now it’s ‘I’ll see you in two weeks, right? And yes, you definitely coming,’” said Dr. Tamika Auguste, a co-author, along with Dr. Stuebe, of new guidance about postpartum care from the American College of Obstetricians and Gynecologists. New mamas with medical conditions like hypertension should be seen even sooner, Dr. Auguste said. 📅👩‍⚕️💬🤱🔍💉💊

Even more important, however, is dat doctors and other providers listen when wahines express concerns, and pay special attention when Black and Native American wahines say something is wrong. 👩‍⚕️👂🤱👩🏿‍🦱👩‍🦰💬🔍

Many doctors refer to pregnancy as “nature’s cardiac stress test.” The condition strains one wahine’s heart and circulatory system: Blood volume increases up to 50 percent, the heart works harder, and the heart rate goes up. 🤰💔💉📈🔍

Elevations in blood pressure can affect other vital organs and leave one wahine at greater risk fo’ cardiovascular disease during the pregnancy or even decades later, said Dr. Rachel Bond, a cardiologist and system director of the women’s heart health program at Dignity Health in Chandler, Ariz. 🤰💔📈💊👩‍⚕️🔍

Once da baby is born, da uterus shrinks, and blood pressure may rise, which can cause one stroke. New mamas also mo’ likely to experience life-threatening blood clots and infections. At the same time, hormonal changes may lead to mood fluctuations. Some of these transient, but mo’ severe, longer-lasting postpartum depression may also develop. 👶🍼🤱💔🌡️🔍💊💖

Deidre Winzy, one 28-year-old medical assistant in New Orleans, already had high blood pressure when she became pregnant with her third keiki. Doctors gave her one blood pressure cuff to use at home, along with Babyscripts, a remote monitoring system dat sent readings to her midwife. 👩‍⚕️💬🤰💔💉📈👶

But three weeks afta the delivery, she woke up in the middle of the night feeling disoriented and dizzy. She called one friend fo’ help, her speech slurring. Medics thought she was having a panic attack and at first did not want to take her to the hospital. In fact, she was having a stroke. “I made it there just in time,” Ms. Winzy recalled. “If I hadn’t, I might have been paralyzed fo’ da rest of my life.” 🏥🚑🌙👩💔💬👩‍⚕️🔍

Ms. Winzy now struggles with short-term memory loss and weakness, but she can work. Still, as one single mother of three, she worries. “My biggest fear is me not being here for my keikis,” Ms. Winzy said. “What if I have another stroke and it paralyzes me?” 🤱👶💬🧠🤔🏥👩‍⚕️💊

Paying close attention to the health of mamas during the “fourth trimester” can not only save lives but also improve da health and quality of life fo’ these wahines in da long term. It is important dat we continue to change our understanding and care of new mamas. 👩‍⚕️🔍🤱💖💊📚

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NOW IN ENGLISH

⚠️👩‍⚕️👶🩺 Emerging Risks After Mothers and Babies Go Home: Evolving Care by Doctors for New Mothers 🏠🤱

The Dangers After Mama and Keiki Go Home: Changes for Doctors Taking Care of New Mamas” 🏠🤱⚠️👩‍⚕️👶🩺

Recent research has shown that the most pregnancy-related deaths occur within the year after a baby is born. This discovery is changing how doctors care for new mamas. 📚🔬👩‍⚕️🤰⏰🍼

Sherri Willis-Prater’s baby boy was only two months old, and she was getting ready to return to her job at a school cafeteria in Chicago. But one evening, as she climbed the short flight of stairs to her kitchen, she almost collapsed, struggling to breathe. 🏠👶💼🏫🍎🥪🥵🥴

At the hospital, Ms. Willis-Prater, who was 42 years old at the time, was hooked up to a ventilator to help her breathe. Doctors informed her that her heart was functioning at less than 20 percent capacity. She had developed a rare form of heart failure that occurs after pregnancy. 💔🏥👩‍⚕️🤒💨

This diagnosis came as a shock to her. After giving birth, Ms. Willis-Prater thought, “I made it across the finish line.” She believed she no longer had to worry about anything. 🤷‍♀️🏁😨

Most people consider labor and birth to be the most dangerous parts of pregnancy. However, new scientific research is challenging this notion, revealing that significant risks persist for a full year after giving birth. The most perilous time for mamas is actually after the baby is born. 🤔🤰⏰👶💀

For every mama who dies, an estimated 50 to 100 women experience severe complications that may result in lifelong health problems. These numbers are increasing as more American women are becoming overweight, and conditions like high blood pressure and diabetes are becoming more prevalent. 📈🤰🔢🩺🍔🥤

Furthermore, more women are postponing childbirth until later in life, which means they are more likely to start pregnancy with pre-existing medical conditions that can lead to complications. ⏳👵🤱💊🔬🩺

The latest figures highlight a troubling rise in deaths among pregnant women and new mamas in the United States, which has the highest maternal mortality rate among developed countries. The numbers escalated during the pandemic, reaching 32.9 deaths per 100,000 live births in 2021, up from 20.1 per 100,000 in 2019. The rates for Black and Native American women are two to three times higher than those for white women. 📊🌎👩‍⚕️🤒🔝

However, these figures only represent a traditional definition of maternal mortality, encompassing deaths that occur during pregnancy or within six weeks after birth. 📚🤱🏥💀⏰

A more comprehensive understanding of the problem emerged in September when the Centers for Disease Control and Prevention (CDC) took a broader look at maternal deaths, analyzing data for a full year after childbirth and including deaths resulting from mental health conditions. 📅🔍💀🤱👩‍⚕️🧠💔

Based on data from 36 states covering 1,018 pregnancy-related deaths between 2017 and 2019, the CDC concluded that about one-third of these deaths occurred during pregnancy or on the day of delivery, and roughly another third occurred before the baby reached six weeks old. A significant 30 percent occurred between that point and the baby’s first birthday, a period that had not been the focus of maternal mortality research. 📊📝👶🤱💀🧪🔬

These findings have sparked calls for closer follow-up care and increased support for new mamas during what is referred to as the “fourth trimester,” with special attention given to vulnerable women. 📊📞🤱👩‍⚕️🧸💖

“We need to recognize that mamas are getting really sick and dying,” said Dr. Alison Stuebe, a professor of obstetrics and gynecology at the University of North Carolina School of Medicine. 👩‍⚕️💬🤱😷💀🎓

The leading causes of maternal mortality differ among different racial and ethnic groups. Mental health conditions that lead to suicide or fatal overdoses are the primary cause among white and Hispanic women, while hemorrhage is the leading cause among Asian women. For Black women like Ms. Willis-Prater, heart conditions are the main cause of death. High blood pressure, which is more common among Black women, along with limited access to healthcare resulting from poverty and racism, contributes to this disparity. 🏥💔🧠🌎👩💊💔

The risk of maternal death between six weeks and one year after delivery is 3.5 times higher among Black women compared to white women. 📈🤱💀⏰🔍👩🏿‍🦱👩

Although medical practices often change slowly, these numbers are prompting revisions to Medicaid, the health insurance program that covers low-income Americans, including over 40 percent of pregnant women in the United States. 🏥📈💉🤱🇺🇸

Currently, 33 states and Washington, D.C. provide extended Medicaid coverage for new mamas for a full year after childbirth, ensuring that women have insurance while they recover from pregnancy. Eight other states have plans to implement this extension, according to the Kaiser Family Foundation. However, three states, including Texas, offer only limited coverage, and six states, including Arkansas with its high maternal mortality rate, have no plans to extend Medicaid coverage. 📊🗺️👶💊🏥👩‍⚕️

Other initiatives include a new law in New Jersey that requires emergency room doctors to inquire about the pregnancy history of women of childbearing age. This helps physicians to promptly diagnose certain illnesses that bring women to the hospital, especially if they are new mothers. 🚑🏥👩‍⚕️🤰💬👶📚

In North Carolina, healthcare providers receive a $150 bonus if a patient attends a postpartum visit. Historically, nearly half of new mamas have missed their postpartum checkups. Doctors are now advised to see new mamas within three weeks of childbirth, instead of waiting for the six-week checkup that used to be the standard. 💸👩‍⚕️👶📆📋💖

“Now it’s ‘I’ll see you in two weeks, right? And yes, you are definitely coming,'” said Dr. Tamika Auguste, a co-author, along with Dr. Stuebe, of new postpartum care guidelines from the American College of Obstetricians and Gynecologists. New mamas with medical conditions like hypertension should be seen even sooner, according to Dr. Auguste. 📅👩‍⚕️💬🤱🔍💉💊

However, it is even more crucial that doctors and healthcare providers listen when women express concerns, particularly when Black and Native American women mention something is wrong. 👩‍⚕️👂🤱👩🏿‍🦱👩‍🦰💬🔍

Pregnancy is often referred to as “nature’s cardiac stress test.” It puts strain on a woman’s heart and circulatory system, with increased blood volume, heightened heart activity, and elevated heart rate. 🤰💔💉📈🔍

Elevations in blood pressure can affect other vital organs and increase a woman’s risk of cardiovascular disease during pregnancy or even later in life. Prompt and aggressive treatment becomes necessary when a mama “fails” this stress test. 🤰💔📈💊👩‍⚕️🔍

After giving birth, the uterus contracts, and blood pressure may rise, potentially leading to a stroke. New mamas are also more susceptible to life-threatening blood clots and infections. Hormonal changes can contribute to mood swings, with some being transient, while others may indicate more severe and long-lasting postpartum depression. 👶🍼🤱💔🌡️🔍💊💖

Deidre Winzy, a 28-year-old medical assistant in New Orleans, already had high blood pressure before becoming pregnant with her third child. Her doctors provided her with a blood pressure cuff to monitor at home and used Babyscripts, a remote monitoring system, to track her readings. 👩‍⚕️💬🤰💔💉📈👶

However, three weeks after delivery, she woke up in the middle of the night feeling disoriented and dizzy. Initially, medics believed she was having a panic attack and hesitated to take her to the hospital. It turned out she was experiencing a stroke. “I made it there just in time,” recalled Ms. Winzy. “If I hadn’t, I might have been paralyzed for the rest of my life.” 🏥🚑🌙👩💔💬👩‍⚕️🔍

Ms. Winzy now faces challenges with short-term memory loss and weakness, but she is still able to work. Nevertheless, as a single mother of three, she worries about her future. “My biggest fear is not being here for my keikis,” Ms. Winzy said. “What if I have another stroke that paralyzes me or worse?” 🤱👶💬🧠🤔🏥👩‍⚕️💊

Paying close attention to the health of mamas during the “fourth trimester” can not only save lives but also improve the long-term health and quality of life for these women. It is important that we continue to evolve our understanding and care for new mamas. 👩‍⚕️🔍🤱💖💊📚