Pregnancy puts many women on high alert: They become more aware of what they're eating and doing, with a focus on being as healthy as possible. They might omit sushi, limit hair dye and nail polish, and take handfuls of supplements, with everything feeling like a life-or-death decision. But it turns out that the things many women have been worrying about aren't nearly as dangerous as some things that are far more commonplace, and therefore, perhaps even more ominous.
In fact, even though pregnancy-related deaths appear to be on the rise, a new report published in the American Journal of Public Health reveals that what most frequently kills pregnant women (or new moms) isn't usually the actual pregnancy itself. Rather, it's accidental injuries, someone killing the woman, or suicide. The researchers took into account all women in Philadelphia who appeared to have died from their pregnancy either mid-pregnancy or within a year of being pregnant between 2010 and 2014. Nearly half of the deaths, they found, were from the aforementioned causes. There were three common threads among many of these deaths: substance abuse, mental illness, and violent partners - even in women who didn't die from overdoses, suicide, or homicide, respectively.
"Even women who died from medical causes frequently had histories of substance use disorder, serious mental illness, or partner violence - hidden potential contributors to maternal mortality," lead author Pooja Mehta, M.D., assistant professor of obstetrics and gynecology at Boston University School of Medicine, said in a statement. And the worst part is that these deaths may have been preventable if friends, family, and doctors knew what signs to look for and what questions to ask, she added.
The medical and mental or social aspects of pregnancy aren't separate entities, either. Physical changes brought on by the pregnancy can make women more vulnerable to these other issues. For instance, hormone fluctuations can bring on serious depression or make existing mental illnesses worse, according to Harvard Medical School's research. Pregnancy also makes a woman more physically vulnerable, putting pregnant women at a higher risk of domestic abuse, with nearly one in six being victimized, according to the March of Dimes.
It's not that it isn't important to talk about all the medical and environmental factors that go into having a healthy pregnancy, and women should do everything they can (within reason) to protect their bodies. But, "an approach that relies on a broader framework to define the 'preventable' pregnancy-associated death and leverage health system contacts to address mental illness and social context is vital to addressing the U.S. maternal health crisis," Mehta said in the statement.
Further, if people truly want to save the lives of mothers and babies, they need to talk about what's really going on with women, beyond the baby's health - as a woman's physical and mental health is paramount during pregnancy.
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