What your doctor should be asking about your pregnancy risks

ATLANTA - Becoming a mother can be one of the happiest times in a woman's life, and one of the riskiest.

About 700 women in the US die each year and about 50,000 experience severe complications during and in the months immediately after their pregnancy.

There are also stark racial disparities in pregnancy outcomes.

Black women in America are 3 to 4 times more likely to die from pregnancy-related causes that to white women.

Calling maternal mortality "a public health crisis," March of Dimes says the number of women dying of pregnancy-related complications has doubled in the past 25 years.

And, no state has more maternal deaths than Georgia, according to a 2016 report.

Dr. Lisa Waddell, Deputy Medical Director for March of Dimes, recently participated on a maternal and infant mortality panel at Morehouse School of Medicine's annual HeLa Women's Health Symposium. She says healthcare providers and the women they care for need to be having a frank discussion about their risk factors for complications, and what to do to lower those risks. The problem, Dr. Waddell says, is complex.

"We know now that it's really important for us to peel the onion back, and to ask those underlying questions that might be influencing the outcomes," Dr. Waddell says.  "We all want the best for our patients, and the patients want the best for their newborns."

Some of the most common severe pregnancy-related complications are bleeding, high blood pressure, cardiovascular problems, seizures and depression.

The Centers for Disease Control and Prevention estimates about 60% of maternal deaths are avoidable.

So, if you're expecting, Waddell says your doctor should be asking some key question.

"It's important for physicians to ask, you know, 'How are you feeling? Are you taking any medications that we might need to change?'" Waddell says.

But, that's not all.

Waddell says providers need to look beyond your prescriptions, weight and blood pressure, asking about something else that can affect the outcome of your pregnancy: the stress in your life.

Access to quality prenatal and postpartum care is another challenge.

Dr. Waddell says women in rural Georgia often live in “maternity care deserts,” where there aren't enough healthcare providers, and smaller hospitals may not be equipped to handle a major birth complication like hemorrhaging.

She says experience has taught her, if you make it each for women to get the care they need, they will do it.

"But if they've got a barrier, where they cannot get off work, they don't have paid leave, they're concerned about their job, or can't easily get to the provider, we have to take all of that into consideration," Waddell says.