Recent studies have revealed a disturbing rise in pregnancy-related hypertension, a condition contributing to increased maternal mortality rates in the United States. The tragic death of Sara McGinnis from eclampsia, a severe form of pregnancy-related high blood pressure, underscores the critical need for improved maternal health monitoring and treatment. This condition, characterized by persistently high blood pressure, has doubled in frequency since 2007. The medical community is responding with updated guidelines, but the battle to incorporate life-saving changes into everyday care continues.
In 2018, Sara McGinnis, a pregnant woman from Kalispell, Montana, experienced unusual symptoms, including swelling, fatigue, and dizziness. Despite reporting her concerns to her doctor, she was reassured that her symptoms were common for pregnancy in the summertime. Tragically, just two days later, Sara suffered a massive stroke on her way to the hospital and passed away after giving birth to her son, Owen, through emergency delivery. Sara’s death was caused by eclampsia, a severe complication of high blood pressure during pregnancy.
Sara’s case is not an isolated incident. The prevalence of high blood pressure during pregnancy, both chronic and newly developed, has almost doubled in the past decade. Despite more frequent testing, maternal mortality rates are climbing, with hypertension ranking as one of the leading causes of death among expectant mothers. The American College of Obstetricians and Gynecologists has lowered the threshold for when doctors should treat high blood pressure during pregnancy, but implementing these standards remains a challenge.
The reasons for the surge in pregnancy-related hypertension remain unclear. Although some risk factors, such as obesity and advanced maternal age, contribute to the condition, younger and healthier pregnant women are also being affected. Racial disparities are also evident, with Black and Indigenous women facing a much higher risk of developing severe complications. The condition often acts as a “natural stress test,” exposing underlying cardiovascular vulnerabilities that may have gone unnoticed before pregnancy.
Preeclampsia, the most well-known form of pregnancy-related high blood pressure, can lead to organ damage and is sometimes fatal if left untreated. The condition typically resolves after the birth of the baby, but in some cases, it can persist or develop postpartum. Medication can help manage preeclampsia by controlling blood pressure and preventing seizures. In extreme cases, doctors may recommend delivering the baby early to protect both mother and child.
Federal agencies and medical institutions are working to address the rise in maternal hypertension. In Montana, the implementation of federal patient safety guidelines has led to a significant improvement in timely care. More than two-thirds of hospitals now meet these guidelines, up from just over half in 2022. Despite these gains, medical professionals like Annie Glover of the Montana Perinatal Quality Collaborative acknowledge that fully incorporating these guidelines into hospital practices takes time.
Experts emphasize that continuous monitoring of blood pressure during and after pregnancy is essential to catching dangerous trends before they escalate. Stephanie Leonard, an epidemiologist at Stanford University, notes that hypertension in pregnancy is both measurable and treatable, making regular monitoring a key strategy in reducing maternal deaths. Unfortunately, inconsistent monitoring practices, as seen at Bozeman Health, reveal gaps in care that need to be addressed.
Mary Collins, a 31-year-old from Helena, Montana, developed preeclampsia during her pregnancy. Despite being physically active and not fitting the typical risk profile, she experienced rapid weight gain and fatigue. After being diagnosed with preeclampsia, she had to deliver her daughter two months early. Both Mary and her daughter survived, but the experience highlights the unpredictability of the condition.
In contrast, Emma Trotter, who developed high blood pressure postpartum, was initially dismissed by her healthcare providers. Only after her condition worsened during her second pregnancy did she receive the urgent care needed to prevent a life-threatening stroke. Her case illustrates the necessity for clear guidelines and consistent application of hypertension protocols during and after pregnancy.、
While efforts are being made to combat the rising rates of hypertension in pregnancy, many challenges remain. More comprehensive training, better hospital protocols, and expanded access to maternal care are necessary to prevent tragedies like Sara McGinnis’ death. The federal government has increased funding to ensure that hospitals adopt best practices for managing high blood pressure, but gaps in care still persist.
Pregnancy-related hypertension is a growing threat to maternal health in the United States. Although recent advances in monitoring and treatment guidelines offer hope, the rise in maternal deaths indicates the urgent need for better care. As hospitals work to incorporate life-saving practices, continuous vigilance and research are essential to protecting the lives of expectant mothers.
