Addressing Pre-Pregnancy Risk Factors to Improve Maternal Morbidity and Mortality

By Dr. Damali Campbell-Oparaji Associate Professor Division of General Ob/Gyn, Rutgers-New Jersey Medical School and Attending Physician at University Hospital and Deena Cohen, Director of Community Affairs and Relations, GoMo Health

With the new year here and Maternal Health Awareness Day approaching, what better time to refocus efforts on improving maternal health?

As noted in the PRAMS report, “Maternal Risk Factors and Adverse Birth Outcomes,” published in April 2022, it’s essential for pre-pregnancy medical problems to be well-managed and controlled to help reduce severe maternal morbidity and mortality. Health care providers can partner with women and mothers to address maternal risk factors both before and during pregnancy.

Strategies providers and other health professionals can use for women in their reproductive years include:

1. Promote healthy methods to manage chronic and toxic stress for patients, including walking, exercise, meditation, positive affirmations, and creative activities like drawing or writing.
2. Educate patients on “pregnancy spacing,” the time between giving birth and getting pregnant again, after a live birth, stillborn, or miscarriage. Generally, after a full-term birth, waiting at least six months before getting pregnant again is recommended to reduce risks associated with short-interval pregnancy (i.e., anemia, preterm birth). However, each patient’s medical and pregnancy history should factor into the recommendation made by their health care provider.
3. Encourage patients to focus on leading a healthier lifestyle, especially when attempting to become pregnant. This includes regular daily exercise (movement outside of routine tasks or work), drinking six to eight glasses of water daily, and eating two servings of fruit and three to five servings of vegetables daily. The more colorful the fruits and vegetables, the more nutrients they provide. Patients should also limit or cut out smoking, vaping, nicotine, marijuana (inhalation or edibles), and alcohol (including beer and wine) when trying to get pregnant. Studies show that heavy marijuana use by either partner is associated with infertility problems.
4. Empower patients to know their specific health statistics, including blood pressure, cholesterol levels, height, and weight.
5. Inform patients considering pregnancy to keep their provider informed. Before getting pregnant, patients should schedule a visit to address any potential risk factors that could adversely affect their pregnancy or baby.

Educating Women With Resources and Support Outside the Provider’s Office

Being able to reach and educate women outside of annual well visits is key to preventing maternal morbidity and mortality and reducing risk for families. Particularly before pregnancy, it’s essential for providers to ensure patients have equitable access to resources and support for pregnancy planning, early entry into prenatal care, and community resources and/or referrals.

The GoMo Health EarlyCare program is a mobile engagement solution that directly reaches this population. By facilitating increased communication between health care providers and patients, women can more easily access the resources, education, and emotional support they need to reduce the likelihood of maternal risk factors. EarlyCare allows patients to instantly provide updates on their pregnancies and health concerns which, when necessary, can be quickly escalated to the appropriate care team.

How wonderful would it be for every patient to have access to accurate and easily digestible information?