A recent study from Northwestern Medicine has shed light on a concerning increase in severe maternal health complications and birth issues in Illinois between 2016 and 2023. The research reveals that chronic health conditions affecting pregnancy, such as high blood pressure, gestational diabetes, mental health disorders, and particularly obesity, have surged in the state. These rising rates of health complications have led to worsened maternal outcomes despite ongoing statewide quality improvement efforts.
Study Findings: A Troubling Trend
Published in the journal Obstetrics & Gynecology Open on November 21, 2024, the study examined over 988,000 births across 127 hospitals in Illinois from January 2016 to June 2023. It found that the overall rate of severe maternal morbidity (SMM) increased from 1.4% in 2016 to 2% in 2023. Key complications included:
- Vaginal birth complications: A 22.4% increase.
- Cesarean birth complications: A significant 48.9% rise.
- Obesity: This condition saw the most significant increase, with annual rates soaring from 7.8% in 2016 to 22.3% by mid-2023.
- Gestational diabetes: Rose from 4.2% to 5.5%.
- Mental health disorders: Depression increased from 2.5% to 6.6%, while anxiety rose from 3.1% to 10.4%.
Other chronic health conditions like hypertensive disorders and anemia also contributed to these trends. Additionally, racial disparities were stark: non-Hispanic Black mothers experienced more than double the rate of severe maternal complications (2.6%) compared to non-Hispanic white mothers (1.1%).
Racial and Socioeconomic Disparities
The study also highlighted troubling racial and socioeconomic disparities in maternal health. Non-Hispanic Black women faced significantly higher rates of complications, and living in high-poverty areas was shown to elevate risks across all racial groups. These findings underscore the importance of addressing social determinants of health, such as race and income, in efforts to reduce maternal morbidity.
Dr. Lynn Yee, co-author of the study, emphasized that the rising rates of maternal health issues reflect a broader national trend linked to worsening pre-pregnancy health in the reproductive-age population. She noted, “Our findings underscore the role of social determinants of health, such as race and income, in driving disparities in maternal health.”
Health Counseling: A Key Solution
The study stresses the importance of health counseling before pregnancy, especially for individuals with chronic health conditions. Dr. Mugdha Mokashi, the corresponding author, highlighted the role of pre-conception counseling in optimizing health before pregnancy. “It’s crucial for people thinking about pregnancy to screen for any chronic conditions they may have and work on improving their overall health,” she said.
Not Just Age: The Rising Prevalence of Health Conditions
While it is commonly assumed that maternal complications are linked to older age, the study found that even younger pregnant individuals are experiencing more medical conditions. The increased prevalence of obesity, gestational diabetes, hypertension, and mental health issues is not solely due to maternal age, but rather a reflection of rising chronic health conditions among people of all ages.
What Can Be Done?
To address these growing concerns, the study authors suggest several policy initiatives and healthcare reforms that could improve maternal health outcomes:
- Poverty alleviation policies: Efforts such as Illinois’ proposed refundable child tax credit (House Bill 4917) have demonstrated promise in improving maternal health by addressing economic hardship.
- Perinatal quality initiatives: Programs in California have already reduced postpartum hemorrhage-related morbidity, and the Illinois Perinatal Quality Collaborative is focusing on reducing cesarean births and addressing racial disparities in birth outcomes.
- Doula and patient navigator programs: Increasing access to doula services and patient navigator programs can offer valuable support for pregnant individuals, especially in low-income or marginalized communities. Northwestern’s research on patient-navigator programs has shown promise in reducing care disparities and improving postpartum outcomes.
Furthermore, the passage of the Black Maternal Health Momnibus Act in 2023, a series of 13 bills aimed at improving maternal health, would provide essential funding and support for quality initiatives, data collection, and prevention programs.
Conclusion
This new study from Northwestern Medicine highlights the concerning rise in maternal health complications in Illinois, driven by chronic health conditions such as obesity, high blood pressure, and mental health issues. The study calls for urgent action to address the underlying factors contributing to poor maternal outcomes, particularly racial and socioeconomic disparities. By improving pre-conception health counseling, addressing economic inequalities, and expanding support programs for underserved populations, Illinois can work toward better maternal health outcomes for all.