Severe pregnancy complications are on the rise in Illinois, disproportionately affecting black mothers

Chronic health problems are causing an alarming spike in severe pregnancy complications in Illinois.

New Northwestern Medicine Study found that more patients developed high blood pressure, gestational diabetes, mental health problems and obesity during pregnancy. This trend is even worse for black women and people living in poor areas.

The increase in Illinois mirrors national increases in obesity, hypertension and gestational diabetes in pregnant women of all ages.

“Racial disparities in maternal health care are not new,” said Dr. Mugdha Mokashi, a resident in the department of obstetrics and gynecology at Northwestern Medicine and one of the study investigators.

“So the fact that nothing has improved, even though we’ve known about these problems for a long time, is really very concerning.”

Black women were more than twice as likely to experience serious complications compared to their white counterparts, according to the study.

Northwestern researchers studied nearly 1 million hospital births in Illinois between January 2016 and June 2023. During this time, the overall rate of severe maternal morbidity increased from 1.4% to 2%. Severe maternal morbidity describes life-threatening complications that can occur during pregnancy and childbirth, as well as immediately after birth.

Complications for vaginal births increased by 22%, and complications for cesarean sections increased by almost 50%.

These chronic diseases can put a pregnant woman and her baby at risk during pregnancy and childbirth. “They are all connected to each other,” Mokashi said. Mental health problems such as chronic stress can increase a person’s blood pressure. High blood pressure increases the risk of developing diabetes during pregnancy.

And while obesity isn’t a perfect predictor of poor health (people can be healthy at any weight, Mokashi says), the condition is associated with high blood pressure and diabetes.

“These are life-limiting long-term consequences,” Mokashi said.

Researchers say the solution to this surge is to implement stronger policies that help lift people out of poverty and improve access to health care.

“Our findings highlight the role of social determinants of health, such as race and income, in exacerbating maternal health disparities, suggesting that efforts to reduce maternal morbidity must consider both racial disparities and economic hardship,” said Dr. Lynn Yee, author research and physician in maternal-fetal medicine at Northwestern University.

Although more people are postponing pregnancy until later in their childbearing years, the rise in severe complications is not just related to age, Mokashi says. Pregnant women aged 20 to 29 years also suffer from these chronic diseases.

Part of the problem, Mokashi said, is that not enough pregnant women in Illinois have access to prenatal care.

“There is a huge difference between what is needed and what people can access,” she said. “We know that in Illinois, many people are not getting prenatal care at all.”

And even fewer people interested in having a baby undergo preconception counseling, which gives patients the opportunity to better manage any existing chronic health problems before becoming pregnant.

“Preconception counseling helps people optimize their health so that pregnancy is as safe as possible for them and their families,” Mokashi said. “But these huge disparities by race extend beyond the first prenatal visit and are significantly influenced by structural racism and access to health care.”

These results came as no surprise to Kayla Kinsler, doula and intake coordinator at Chicago Maternity Teaman organization that provides doula services to black families in Chicago.

Poverty also makes it difficult for pregnant women not only to access quality health care, but also to manage chronic conditions such as diabetes and high blood pressure. Eating healthy and exercising may not be possible if you live in a food desert with little green space.

“Addressing social determinants of health will also improve maternal health care,” Kinsler said.

The study identified doula support as one step toward improving maternity care. Doulas are assistants for expectant mothers during pregnancy and childbirth. They help develop birth plans, answer questions, and provide emotional and physical support.

“Doulas are definitely a step toward improving care for pregnant women,” Kinsler said. “We are here to hold their hand. We are another person in the room who advocates for them, talks things through with them and makes sure they are actively involved in their care.”