Newsroom | Collaborative Care

Almost all deaths of pregnant woman in Texas may have been preventable, according to a recent state report. 

Pregnancy and childbirth complications also increased, surging from 58.2 to 72.7 cases per 10,000 deliveries in Texas between 2018 and 2020, according to the report from the state’s Maternal Mortality and Morbidity Review Committee. 

High blood pressure, or hypertension, during and after pregnancy — and seizures resulting from it — are among the leading causes of maternal death.

Although avoidable, complications from pregnancy-related hypertension, called preeclampsia, often go unnoticed because many women don’t have the tools, education or empowerment needed to monitor, maintain and advocate for their prenatal and postpartum health, experts say.

To address this critical issue, March of Dimes Texas received a $45,000 grant from Blue Cross and Blue Shield of Texas (BCBSTX) to distribute hundreds of hypertension kits, including blood pressure cuffs, to maternal health providers. Those providers are working with their patients, teaching them to use the blood pressure cuffs as part of their home health care routines.

“Pregnant women need to be empowered with the knowledge and tools they need to monitor their own health,” says Heather Butscher, maternal and infant health director for March of Dimes Houston. “These hypertension kits will be an integral part of that education and empowerment.”

In 2022, BCBSTX awarded $2.1 million grants to 54 community-based organizations statewide, including the March of Dimes, to improve Texans’ health and wellness. Focal points of the grant program include nutrition, economic opportunity and stability, neighborhood environment and infrastructure, locally defined health solutions and optimal health outcomes.

“We are happy to award these grants that will support and nurture meaningful and transformational projects across Texas,” says Sheena Payne, BCBSTX’s director of Community Investments. “Strategically, it is also important that we continue to aid community-based organizations that are directly supporting children and families with health and wellness equity as well as building foundations for economic opportunity.”

March of Dimes’ initiative targets communities of color disproportionately affected by health disparities and at higher risk for pregnancy complications. Blood pressure cuff use between prenatal visits can help patients and providers identify and treat problems and lower preventable, adverse birth outcomes for mothers and babies, Butscher says.

“This project has been a dream of mine,” she says. “We appreciate the commitment Blue Cross and Blue Shield of Texas has to help change maternal and infant health care.”

Intervention helps reduce deaths and preterm births

Nationwide, high blood pressure happens in as many as 1 of every 12 pregnancies among women ages 20 to 44, according to the Centers for Disease Control and Prevention.

Preeclampsia occurs in about 5% of all pregnancies and is one of the leading causes of maternal deaths. Annually, it is responsible for more than 70,000 maternal deaths and 500,000 fetal deaths worldwide. 

In the United States, the rate of preeclampsia in Black women is 60% higher than in White women. Additionally, Black women more likely are more likely to experience poorer outcomes associated with the condition, including kidney damage and death.

Preeclampsia also can lead to preterm births, says nurse Lakeisha Vallier-Scott, supervisor of Baylor College of Medicine’s Teen Clinic’s Nurse Family Partnership in Houston. Her clinic is among those benefitting from the March of Dimes’ hypertension kit initiative.

“Fortunately, we have not had any deaths related to preeclampsia, but we have had preterm births,” says Vallier-Scott, who oversees five nurses making home visits to pregnant clients ages 13 to 24. “We definitely want them to reach full-term.”

With a limited number of kits to distribute, she and her nurses prioritize which clients receive them — girls and women pregnant with twins are at highest risk for preeclampsia. However, they wish they could give everyone a blood pressure cuff because hypertension can strike at any moment, and quick intervention is imperative.

Vallier-Scott says she and her nurses provide nutrition education and advise clients to be aware of high blood pressure warning signs like headaches and swollen ankles. But young people and even their parents and guardians sometimes don’t grasp the risks high blood pressure can present to them and their babies.

“The day of your prenatal visit, you may have a great blood pressure,” Vallier-Scott says. “And after a home visit, my blood pressure cuff is going with me. So, giving clients a blood pressure cuff is better for them.”