By: Silke Schoch, MA, Director of Research & Programs 

As the United States ranks last in safe outcomes for all pregnant patients among similar high-income nations, maternal health continues to be a paramount issue, especially for patients with chronic conditions. Historically underrepresented patients such as those living in rural communities, patients with public insurance like Medicaid, and women of color, also experience poorer outcomes compared to other patients. 

A new research brief, coming next month from the National Health Council (NHC), will explore the relationship between chronic conditions and maternal health pre- and post-birth and strategies for patients, providers, and researchers to improve pregnancy outcomes.  

An estimated one in three Americans have chronic disease or condition. These chronic conditions, like high blood pressure, obesity, and diabetes, have a direct association with negative pregnancy outcomes and may significantly increase a pregnant patient’s risk of injury or death. Mental health conditions are currently the leading cause of pregnancy-related deaths overall in the United States. When present before pregnancy, diabetes and high blood pressure can lead to dangerous conditions such as preeclampsia. It is essential for patients to work closely with their care team before and during pregnancy to manage chronic conditions and reduce risks.   

Patients without preexisting chronic conditions can develop them as a result of pregnancy and delivery. For example, severe perineal tears from childbirth can lead to mental health concerns like depression and posttraumatic stress disorder. Patients who had high blood pressure only during pregnancy were still at risk for the condition multiple years after birth. Similarly, gestational diabetes mellitus increases a patient’s lifetime risk of developing type 2 diabetes. 

However, most deaths and injuries due to pregnancy and birth are preventable.  Improving outcomes, especially for patients with preexisting conditions, requires collaboration across research, clinical care, and patient advocacy. To make meaningful progress, maternal health resources, education, and studies must include the voices and live experiences of patients with lived experience, whose insights are essential to improving care.  

The full NHC research brief on maternal health and chronic conditions will be published in August. Explore other NHC research briefs on a variety of topics from extreme heat to nutritional health here.