Health Experts, Community Speak Out About Maternal Heart Disease in Black Mothers, What’s Next  

After all the chaos, it was in those quiet early morning hours late last June that Jessica McCall-Kailimi, 32 of Oak Park, found her peace in the form of a nurse who soothed her soul.

 

McCall-Kailimi gave birth two weeks early to her second daughter, Ava, [at Beaumont Royal Oak] and the empathic mother’s journey of having her was traumatic, though, triumphant.

 

After giving birth, McCall-Kailimi hemorrhaged, had life-threatening complications, needed emergency surgery to remove blood clots and part of her placenta that was still attached. At one point she thought her time was up here after blacking out on the surgery table from so much blood loss.

 

“I feared for my life. Who would have thought that having a baby could have killed me?” McCall-Kailimi said. “I said, ‘This is it. My baby is 12 hours old — this is how my story ends.’ It was scary for me.”

 

Coupled with dealing with family issues [that left her primarily alone in the hospital] she needed reassurance that she was going to make it. And she indeed did.

“I had an African American nurse who prayed for me. I came back from the surgery and she said that I had been through so much,” McCall-Kailimi said, adding that the nurse hugged her, too, and held her baby.

 

“She was that mother figure that I needed at that time … She was maybe only a few years older than me. She said, ‘Take care of yourself; you’re going to be OK.’ That comment meant so much to me … I think at that moment I knew I was going to be OK,” McCall-Kailimi said, choking up a bit through her tears. “It felt even better coming from a woman of color; she really saw me deeper than a patient.”

Shortly afterward, McCall-Kailimi made it home with her baby and dealt with another scary situation: postpartum preeclampsia, or high blood pressure. Her feet, legs, and other body parts ballooned three times their normal size and at one point her blood pressure was 190/120.

“I had no idea; my heart wasn’t racing — [there] no symptoms except for the swelling,” McCall-Kailimi, who is fit and had no problems during pregnancy, said.

 

McCall-Kailimi [who has a background as an integrated infant mental health therapist] encourages mothers to connect with a healthcare provider who listens to them. “If you feel like you’re not being heard, change providers.”

 

Black women like McCall-Kailimi experience higher rates of health-related complications as it relates to pregnancy and postpartum care. The American Heart Association noted in a recent press release that significant racial disparities exist in heart-related problems among pregnant and postpartum women in the United States, with Black women having the highest risk of several major complications, according to research published recently in the Journal of the American Heart Association, [AHA] an open-access journal of the AHA.

“Clinicians should be aware of the cardiovascular risks associated with pregnancy that, although not common, can result in serious illness and death. Women at increased risk for heart disease should be closely monitored during and even after pregnancy,” said Samir R. Kapadia, M.D., senior author of the study and chair of the department of cardiovascular medicine at the Cleveland Clinic in Cleveland, Ohio.

 

Heart disease, stroke, and pregnancy-related complications are among the top-10 causes of death in women ages 20-44 in the United States, based on the most recent official data available. To look at the fullness of racial disparities in the risk of heart problems during pregnancy or after delivery, Kapadia and colleagues reviewed health records for more than 46 million hospitalizations of pregnant or postpartum women included in the National Inpatient Sample, the largest U.S. database detailing inpatient hospital care in 47 states, between 2007 and 2017, according to the report.

 

Also after adjusting for socioeconomic status, access to health care, and other medical conditions, researchers found that compared to white women, pregnant Black women were:

      45% more likely to die in the hospital;

      23% more likely to have a heart attack;

      57% more likely to have a stroke;

      42% more likely to develop a blood clot in the lungs; and

      71% more likely to develop heart muscle weakness.

       

“The magnitude of disparity was most alarming,” said Kapadia in the release. “We were very surprised by the persistent disparities irrespective of socioeconomic status. Attributing worse outcomes in Black women to socio-economic status or differences in health care delivery may be an oversimplification.”

“Cardiovascular health in women should not be taken for granted and pregnancy provides a reasonable mirror for the future,” Kapadia added in the release. “When women have problems during pregnancy, they should be followed carefully after pregnancy and actions should be taken to prevent heart problems.

“We need a better understanding of the root causes of these disparities in order to mitigate them. The aim is to deliver equitable cardio-obstetric care to all pregnant women,” Kapadia said.

 

Kristian Hurley, senior director, Community Impact, American Heart Association, Southeastern Michigan, said that her team looks at the risk factors that Black women, and other minorities, have and addresses them, in particular high blood pressure and hypertension.

Working in the city of Detroit, Hurley said her team asks: “How do we make the environment that is around Black women healthier? “We focus on where people live, work, play, pray.”

Hurley said her team works in the faith-based communities to ensure they are educating their membership about healthy lifestyles and what people can be doing to work on their weight and blood pressure.

“If they can get it under control they are less likely … to develop cardiovascular disease or stroke,” Hurley said. “We do a lot of programming in the city and across the state to make sure the care our women are receiving high quality.”

 

Dr. Michelle Voeltz, an interventional cardiologist who also manages high-risk obstetrics patients at Georgia-based Northside Hospital Cardiovascular Institute [who previously worked at Henry Ford Hospital] said that she is focused on improving the heart health in women who are thinking of getting pregnant, are pregnant, or recently delivered.

 

Voeltz said that pregnancy-related cardiovascular disease and general mortality are a “double hit” in Black women when it comes to pregnancy and delivery.

 

She added that there are a number of things Black women can do to combat the grim statistics.

 

“First is preconception counseling. Prior to getting pregnant do risk assessments,” Voeltz said, which comes in the form of “optimizing their medical regimen” to make sure their blood pressure is under good control in pregnancy, among other health improvements.

 

Voeltz added that medications used to control blood pressure should also be safe for baby and breastfeeding.

Voeltz added that it is also critical that medical professionals work closely together and monitor Black mothers “to make sure that we have a multidisciplinary approach for carrying for these high-risk women.”

 

Voeltz echoed McCall-Kailimai’s thoughts of having trusted providers and said it is important that mothers are “feeling connected” to their providers.

 

“As Black women, we certainly have experienced our concerns being minimized by physicians so it is really important that you are cognizant of your relationship with your provider and that you have trust in your provider,” she said. “Advocate for yourselves and advocate for each other,” she said.

 

For more information on the local AHA search for American Heart Association, Southeastern Michigan.

 

For more information go to heart.org and stroke.org.

 

 

 

 

 

 

 

 

 

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