Pregnancy and childbirth are natural, right? But so are related complications. Things don’t always go smoothly with the pregnancy or the delivery, and women can die during a time that is supposed to be a wonderful experience.

Some countries are improving maternal care and reducing complications, but, every day, hundreds of women around the world still die. Most maternal deaths occur in developing countries, but some developed nations, like the United States, are seeing rising numbers. Each year about 700 women in the U.S. die of pregnancy-related complications. Experts say that two-thirds of these deaths are preventable. A new program launched by the U.S. Centers for Disease Control and Prevention, HearHer, aims to reduce these deaths.

Most common pregnancy-related complications

Some women develop complications because of medical conditions that existed before they became pregnant. For example, a woman with hypertension or diabetes before pregnancy must be monitored closely by her obstetrician and her specialist to ensure she stays safe. But other women develop new problems while pregnant.

The most common complications, which the World Health Organization says account for nearly 75% of all maternal deaths, are:

  • Bleeding
  • Infection
  • Pre-eclampsia and eclampsia (severely high blood pressure)
  • Complications from the delivery itself

"In the state of Maryland, the number one cause of associated maternal death is drug overdose which most occur beyond the time of the 6th week visit," Robert O. Atlas, M.D., told Medical Daily. However, he says that they continue to lose a few patients each year to blood clots, infection, heart disease and, now, the Covid 19 pandemic. "I continue to believe physicians have to listen carefully to our patients when they tell us what is going on. I always tell my patients I won’t be able to make a diagnosis on the phone and they must come in. As the data shows, 65% of deaths can be prevented and we need to continue to strive to put processes in place to reduce the risk." Dr. Atlas is Chair of Obstetrics and Gynecology, at Mercy Medical Center in Baltimore.

The March of Dimes says the leading causes of maternal death in the U.S. are heart disease and stroke. The rates of these are up to 3 times higher among women who are Black, American Indian or Alaskan Native than among their white counterparts.

"I have had a few patients in the last year express their fears to me about being a black women and their fear of death. I do think we have to look at this in perspective," Dr. Atlas said. "Delivery in our country is generally safe. We are seeing an increasing risk to our patients mainly driven by the obesity epidemic, which leads to other comorbidities including hypertension and diabetes. The other thing we are seeing are women becoming pregnant later in life which also is a risk factor not only because of age but because of the increased risk of patients having underlying complications. The risk of death is very low in our country but there is a real disparity in those maternal deaths which we need to address."

As the HearHer campaign launched, CDC Director Robert R. Redfield, MD, said in a press release, “Pregnancy and childbirth should not place a mother’s life in jeopardy, yet in far too many instances, women are dying from complications. This seminal campaign is intended to disrupt the too-familiar pattern of preventable maternal mortality and encourage everyone in a woman’s life to be attentive and supportive of her health during this important time.”

The HearHer website is open to the public, and pregnant women and their partners are encouraged to visit to learn more about maternal health. The campaign’s objectives are to:

  • Teach women to recognize warning signs of complications
  • Help women feel comfortable speaking to their healthcare provider about their concerns
  • Encourage the women’s partners or support systems to speak about the issues that may face her
  • Provide women, their support systems, and their healthcare providers with the tools to have those conversations

Signs to watch for during pregnancy

Pregnant women go through many physical changes that support their growing baby and prepare their body for childbirth. It can sometimes be difficult to tell which changes are normal and which may be signs of complications. If you are pregnant and you experience any of the signs or symptoms listed here, contact your healthcare provider right away or go to the closest emergency room:

  • A severe headache that won’t go away or gets worse, especially if you experience changes in your vision or you get dizzy. Some women have described the headache as the worst of their life.
  • Fainting. If you don’t faint but are dizzy, this is also a sign to speak to your doctor.
  • Vision changes, such as seeing spots or flashes of light, or having blind spots, blurriness, or double vision.
  • Fever of 100.4 degrees Fahrenheit, or 38 degrees Celsius or more
  • Swelling in your hands or face. There can be normal swelling during pregnancy, but if you notice that you can’t bend your fingers because of the swelling, or your face has swollen to the point that your eyes are puffy or your lips are swollen, seek emergency help right away.

The Take-Away

Aside from the common discomforts associated with pregnancies, most are fairly trouble-free. This isn’t the case for all women though. Pregnant women should have open and frank discussions with their physicians or midwives about what can happen. Talk about previous health issues, if any. Review urgent maternal warning signs that could appear during or after pregnancy. What should you watch for? What is dangerous? You know your body best and if you feel that something isn’t right, speak up until you have the answers that satisfy you. "We also encourage our patients to ask questions regarding their care," Dr. Atlas said.