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Pregnancy-related deaths in the U.S. have risen 140% over the past three decades, and cardiovascular disease is the leading cause, according to the American Heart Association (AHA),
“A pregnancy-related death is defined as a complication or death that occurs during pregnancy or up to 12 months after delivery,” explains Jacquelyn Caglia, Director of Merck for Mothers. “According to data from the U.S. Centers for Disease Control, 80% of these deaths in the US are completely preventable.”
It is an issue that the AHA has called “a national embarrassment.” AHA observed: “In 2020, the U.S. maternal mortality rate was three times higher than any other high-income country, with stark disparities among White and Black birthing people. Underscoring U.S. disparities, Black individuals have a 3–4 fold higher maternal mortality and a 50% higher risk of severe maternal morbidity as compared with White women.”
Merck for Mothers is Merck’s $650 million global maternal health initiative. To address these issues, Merck for Mothers has provided support to the AHA’s Advancing Maternal Health Through Quality Improvement and Professional Education initiative, as well as the CDC’s Hear Her Campaign. Both campaigns aim to raise awareness of urgent maternal warning signs during and after pregnancy in an effort to help create a world where no woman has to die while giving life.
Hear Her
Joanna’s Story via CDC’s Hear Her Campaign
When Joanna gave birth to her first daughter, everything seemed fine. But she started feeling sick a couple of days later.
“My head was hurting. I started getting extremely swollen in my legs and in my hands,” Joanna, one of the voices of the Hear Her campaign, recalls, “and that never happened to me throughout my pregnancy.”
“What we consistently heard was that people felt something was wrong in their body, but they either didn’t know something could be wrong, didn’t voice their concerns, or didn’t get access to the care they needed,” says Caglia, describing the genesis of the Hear Her campaign. “There were also successful cases where individuals or their partners were able to advocate for themselves, and they were able to get the care that they needed.”
Joanna was dealing with postpartum preeclampsia, a rare but dangerous condition that is categorized by high blood pressure and excess protein in a new mother’s urine soon after childbirth.
“I took my blood pressure, and it was really high,” she recalls, “I was just like, Something’s wrong.” She went to the hospital and was admitted to the ER right away. “They said if I would have stayed home any longer, that it was possible that I could have had a stroke, or I could have possibly even had a seizure or died at home.”
That was not the last time she ended up in the hospital. Joanna returned three more times, with less and less support with each successive visit.
“The third time I went [to the hospital], they were making comments like, You’re here again,” Joanna recalls. “It started to make me feel like they were irritated or I was bothering them. At one point, a doctor did say to me, ‘Just stop checking your blood pressure at home.’ And I was like, ‘How could you say that?’ I felt extremely unheard. I felt like I was dismissed. I felt like I wasn’t being taken seriously.”
With support from Merck for Mothers, the CDC soon found that resources about postpartum health don’t just save lives but also improve new mothers’ mental health and strengthen patient-provider relationships.
“The campaign includes materials like a symptom card that can be available in clinical spaces,” explains Caglia. “We’ve been hearing stories of patients bringing these cards into the emergency room with the signs or symptoms they’re experiencing checked off, using them as a communication tool with their health care team to help them break through and get the care they need.”
With such tools, Merck for Mothers is helping open the communication lines between patients and healthcare teams in both the short- and long-term.
“[Being dismissed] really hurt because these are people that I felt like were supposed to be taking the best care of me in such a vulnerable time in my life,” Joanna concludes. “During those moments, I just felt like if someone heard me, it would have made such a big difference….I will never forget how people made me feel postpartum.”
Postpartum Systems of Care Recommendations
A fierce advocate of working collaboratively to develop solutions for improving maternal health outcomes, Caglia had the following to say about Merck for Mothers support of the AHA and their Advancing Maternal Health Through Quality Improvement and Professional Education initiative, which was launched in July 2022:
“We’re proud to support our strategic collaboration with the American Heart Association,” says Caglia, “which has been leading the effort related to maternal and cardiovascular health as part of AHA’s larger initiative focused on health equity. Through Merck for Mothers, we’ve been able to specifically support the development of materials and the formation of a scientific advisory committee to issue a statement from the AHA on cardiovascular considerations when caring for pregnant individuals, as well as to develop the educational materials that are now being rolled out.”
Most recently, the AHA has unveiled their Postpartum Systems of Care Recommendations, which include recommendations for:
- Standardized clinical education for all health care professionals who may encounter pregnant or postpartum birthing persons;
- Patient-centered holistic care that is standard practice for healthcare providers and institutions;
- Access to comprehensive health coverage through the first 12 months following birth for all postpartum people.
The AHA’s full recommendations also incorporate implementation strategies, short- and long-term objectives, as well as target audience and dissemination strategies in a bid to turn the cultural tide of maternal care in the U.S. in order to make it more available and equitable.
“My hope and wish is that people who are pregnant or have recently welcomed a new baby into their family listen to their bodies, that they have support from loved ones who are also listening, and that health care teams have the tools they need to really hear their patients and ask good questions to better understand what they are going through,” concludes Caglia.
