More pregnant women are being diagnosed with dangerously high blood pressure, which risks the life of the parent and child. Montana is one of the states improving screening and treatment.
JUANA SUMMERS, HOST:
Health researchers are noticing a growing problem when it comes to pregnancy – blood pressure that’s so high, it can be deadly for both mother and baby, and both doctors and patients can miss the symptoms. Here’s Katheryn Houghton with our partner, KFF Health News.
KATHERYN HOUGHTON: Mary Collins has always been healthy. Even at 29 weeks pregnant, she was hiking the trails close to her home in Helena, Mont. Still, something felt off.
MARY COLLINS: I was very swollen. I gained more weight than I expected. I felt just crummy. But all of those things, people are like, that’s pregnancy, you know (laughter).
HOUGHTON: She was at a doctor’s appointment to check on her baby’s growth when she brought up those symptoms. Just minutes before, her OB had said everything looked good.
COLLINS: He pulled up my blood pressure readings, and then he just did sort of a physical assessment. And then he was like, yeah, actually, I guess, like, I’ll take back what I said. I can basically guarantee that you’ll be diagnosed with preeclampsia during this pregnancy, and you should buy life flight insurance.
HOUGHTON: She was going to need that air ambulance, because where she lives in Montana, she is more than an hour-and-a-half away from a hospital that could handle a very premature birth.
COLLINS: We were like, OK, big pivot.
HOUGHTON: Collins was going to get sicker. Preeclampsia is severe high blood pressure in pregnancy, which meant doctors would likely need to induce labor early. With preeclampsia, the heart works in overdrive – that can lead to a stroke or heart attack. It can also cut off key nutrients to the fetus. People who are overweight or have kids later in life have a higher risk. Physician and health researcher Natalie Cameron says lately, more people who don’t have risk factors going into pregnancy are also getting sick.
NATALIE CAMERON: Pregnancy is a natural stress test. It’s unmasking this risk that was there all the time. So people who get gestational hypertension and preeclampsia may have some underlying vascular dysfunction that we just don’t know about, even if they’re very healthy otherwise.
HOUGHTON: The rate of people diagnosed with new hypertension in pregnancy nearly doubled from 2007 through 2019. Some of that is because more doctors are actually looking out for this, which is good, but that’s not enough to explain the increase.
CAMERON: We haven’t been really seeing a slowdown, unfortunately, so we still have a lot of work to do.
HOUGHTON: There’s a list of typical symptoms – swelling, headaches, vision problems or nausea, but sometimes rising blood pressure is the first clue. And physicians have recognized that the number that’s dangerous in pregnancy is lower than the rest of the population. There’s federal money to train hospital workers to better spot that danger and help them know when to treat climbing numbers. Even so, in some health care settings, those best practices still aren’t the norm. Carole Johnson is the head of the federal agency charged with improving access to health care. She says sometimes patients’ symptoms go ignored.
CAROLE JOHNSON: So much of the disparity in this space is about women’s voices not being heard, and that’s why we’re making sure that women have supports like community-based doulas, that community health workers are helping to support them, that we have more midwives in the system.
HOUGHTON: Still, both mom and baby can get really sick. Collins, the new mother in Montana, was still two months away from her due date when she needed that air ambulance.
COLLINS: We were trying to do the balancing act of – how long can I be OK before we have to get baby out? And the doctor said, we need to get this going. You’re just too sick.
HOUGHTON: Her daughter, Rory, was tiny when she was born and spent 45 days in intensive care.
COLLINS: We feel really lucky, and it was still really brutal.
HOUGHTON: Collins and baby Rory are doing better, but that’s taken months. I’m Katheryn Houghton in Missoula, Mont.
SUMMERS: Katheryn’s story comes from our partner, KFF Health News.
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