Understanding the risks associated with pregnancy is a public health matter. The journey to motherhood involves major physical and emotional changes and is not without potential health complications. Awareness of these risks is the first step toward navigating a safer pregnancy. Maternal mortality is defined as the death of a woman during pregnancy or up to a year afterward.
The Leading Cause of Pregnancy-Related Deaths
Cardiovascular conditions are the primary driver of pregnancy-related deaths. This broad category encompasses issues affecting the heart and blood vessels. Data from the Centers for Disease Control and Prevention (CDC) shows that conditions like heart muscle disease (cardiomyopathy), coronary artery disease, high blood pressure, and stroke are contributors.
These cardiovascular problems can exist before pregnancy or develop during it. The strain of pregnancy can exacerbate chronic heart disease. Conditions like peripartum cardiomyopathy, a weakening of the heart muscle, can also emerge in the final month of pregnancy or in the months following delivery, while hypertensive disorders like preeclampsia pose additional risks.
How Pregnancy Affects the Cardiovascular System
Pregnancy alters the cardiovascular system to support a developing fetus, placing an additional workload on the heart and blood vessels. A primary change is an increase in blood volume by 30% to 50% to nourish the baby. This expansion means the heart must pump more blood with every beat.
To manage this increased volume, the heart’s output, known as cardiac output, increases by as much as 45% by the 24th week of gestation. This is achieved through both a higher stroke volume (the amount of blood pumped per beat) and an elevated heart rate. A pregnant person’s resting heart rate typically increases by 10 to 20 beats per minute.
These adaptations are normal for a healthy pregnancy, but they create a demand on the cardiovascular system. For individuals with pre-existing or newly developed heart conditions, this added stress can expose or worsen underlying problems. This provides the biological context for why cardiovascular issues are a leading cause of maternal mortality.
Urgent Maternal Warning Signs
Recognizing urgent maternal warning signs helps protect against severe complications. These symptoms can appear during pregnancy and up to a year after childbirth and should not be dismissed as typical discomforts. Seeking immediate medical care if any of these signs occur is necessary.
Symptoms that demand prompt attention include:
- Severe headache that doesn’t improve
- Dizziness or fainting
- Changes in vision
- Chest pain or a rapidly beating heart
- Trouble breathing
- Severe swelling in the hands or face
- Severe and persistent abdominal pain
- A fever of 100.4°F or higher
Communicate any of these symptoms to a medical professional right away. Be sure to state that you are pregnant or have been within the last year to ensure the proper context for your evaluation.
Other Significant Risks During and After Pregnancy
Beyond cardiovascular conditions, several other complications contribute to maternal mortality. Severe bleeding, or hemorrhage, is a risk that can happen during pregnancy, at birth, or postpartum, and it remains a common cause of death in the United States and globally.
Infection, which can lead to sepsis, is another cause of death. Infections can develop at any point but are a risk after delivery, particularly following a cesarean section.
Mental health conditions also represent a risk, leading to deaths from suicide or overdose. Postpartum depression, for instance, can increase this risk if left untreated. Deaths from embolism (blood clots) also account for a large percentage of maternal fatalities.
The Role of Proactive Healthcare and Advocacy
Consistent healthcare before, during, and after pregnancy is important for maternal safety, as the risk of a pregnancy-related death increases without it. Regular prenatal care allows providers to monitor health, identify risks early, and manage chronic conditions. The American College of Obstetricians and Gynecologists recommends the first prenatal visit occur within the first trimester.
The postpartum period is an important time, as more than half of pregnancy-related deaths occur after the baby is born. Follow-up visits are necessary to screen for and manage complications like high blood pressure, diabetes, and mental health conditions. Openly communicating personal and family health history with providers helps them assess individual risk factors.
Self-advocacy is also important. Individuals should ask questions and voice concerns when something does not feel right. Leading causes of death can vary among demographic groups, and research shows disparities in maternal outcomes exist, particularly for Black and Indigenous women, making it important for every person to be an active participant in their healthcare.