The silent epidemic within the maternal health crisis

First-time mom Breana Williams was preparing for a special time in her pregnancy: the nesting period. What should have been a joyous time for Breana went downhill—quickly. She had persistently high blood pressure, and at 33 weeks along, she started experiencing severe cramping and bleeding. She immediately sought emergency care, ultimately resulting in the delivery of her baby boy prematurely to save his life—and hers. She later learned she had developed preeclampsia and placental abruption, life-threatening complications that led to the preterm birth. Her son spent the first 16 days of his life in the neonatal intensive care unit (NICU), which was frightening for Breana as a new mom who was also fighting to recover. The risk of pregnancy complications Thankfully, Breana and her baby have now recovered and are thriving. However, her story isn’t an isolated one. It shines a spotlight on a disturbing trend boiling within the maternal health crisis in the U.S. Every death of a woman during pregnancy, childbirth, or postpartum is devastating. And for every maternal mortality, more than 70 women come close to death. Women who face these near-death experiences during pregnancy, delivery, and postpartum are called “near misses.” Near misses can be caused by pregnancy complications like preeclampsia, spontaneous preterm birth, and severe hemorrhaging, striking hundreds of thousands of U.S. women annually. Upward of 60,000 pregnant women experience severe maternal morbidity each year, which disproportionately impacts both Black women and moms over age 35.   As soon as mom and baby make it through delivery and are back home, there’s often an expectation to “return to normal” very quickly. Yet the effects of these traumatic experiences can linger. For many survivors, it changes the trajectory of their family planning. Whether they decide to halt growing their families based on medical advice from doctors or because of post-traumatic stress disorder (PTSD) from the experience, it’s heart-wrenching and upsetting. The families these women envisioned and dreamed of fade away. The impact doesn’t stop there. The maternal morbidity epidemic carries an enormous price tag for society: A Commonwealth Fund report found that costs related to these so-called near misses totaled more than $30 billion in the U.S. in 2019. The Status quo isn’t working At this point, it’s very clear: The status quo isn’t working. Rates of preeclampsia—a leading cause of maternal morbidity—have doubled in the past 15 years. Severe maternal morbidity has also doubled over the past two decades. But just like so many maternal deaths, these near misses could be prevented.  Understanding the problem is critical to solving it. The doom-and-gloom headlines continue, but there has not been much explanation as to why negative maternal health outcomes continue to trend upward. Our understanding is so limited around why certain women are at higher risk for developing pregnancy complications, and it limits our ability to mitigate or avoid the complication altogether. For example, once a woman begins to show symptoms of preeclampsia, it’s often too late to prevent the complications it brings. Current approaches focused on preventing complications aren’t working. For example, broad, generalized risk factors lump most pregnancies into the moderate risk group for preeclampsia. For these women, it is arbitrary for clinicians and care teams to create a personalized care plan to reduce their preeclampsia risk. Precision medicine It’s time to bring pregnancy health into the era of precision medicine. We still use a prenatal care paradigm of 12 to 14 prenatal visits that was developed nearly 100 years ago, specifically to detect preeclampsia symptoms and to manage them. If we can biologically understand who’s at risk early in pregnancy and apply preventive care to those identified as high risk, we have a significantly improved opportunity to prevent preeclampsia or mitigate the severity of the disease. It’s frustrating for many women, families, and doctors in the U.S., which is a beacon of medical innovation—yet we lag behind every major industrialized nation in addressing the maternal health crisis. That’s why, as a father myself, I founded Mirvie. We’re applying biological innovation to pregnancy health using RNA to predict preeclampsia months before symptoms appear. Screening tests like this offer tremendous value to everyone involved, from the doctor and care team to the mom and her unborn child. Identifying those most at risk for complications will allow for early intervention, when every action possible can be taken to create a healthy pregnancy. Breakthrough solutions are needed to shatter the status quo and ensure a new, better standard of care for pregnancy health. Pregnancy should be a safe, joyful, and special experience for all—that should be a nonnegotiable reality. I believe that biological breakthroughs in preg