Hospital bills are especially high for pregnancy and delivery. These costs exceed $30 billion in hospital bills and remains the largest groups of diagnoses by cost for employers providing health insurance benefits.
29% of pregnancies in working-age women are unintended. Unexpected pregnancies cost employers about 1% of their total healthcare annual costs. These rates prompt some public health experts to highlight that women need more access to oral contraceptives. Most employers are have few options when it comes to promoting contraception to their employees. Even if it is a way to enhance public health and reduce costs, it is not a domain in which most employers feel comfortable.
On the other hand, another cost driver for pregnant women is the health of their heart. Top modifiable risk factors include substance use (alcohol or drugs), obesity, poor food choices and nutrition, unmanaged blood sugar, and high blood pressure. All show favorable changes within weeks of lifestyle adjustments, emphasizing that prevention is needed to protect the baby and mother through the course of the pregnancy.
During pregnancy, the heart and blood vessels re-organize. There are cardiovascular changes that prepare the body for delivery, including a higher blood volume (up to 50% more blood), more blood pumped per minute (higher cardiac output), a higher heart rate (+10 beats per minute) and in some cases, lower blood pressure. As a result of these imposed demands, with each pregnancy, a woman’s heart increases by about 1.3 grams due to left ventricle growth!
These increased demands can stress the cardiovascular system. Women with pre-existing heart disease may have more difficulties with the process. Widespread changes to the heart and blood vessels can make pregnant women much more vulnerable to fatigue. Feelings of exhaustion are much more common, however, if the woman has entered pregnancy with poor heart health.
A new study reported that of all women who gave birth in 2019, only 40% had good heart health. The top driver of poor heart health was obesity. This information was finally made available a few years ago when all states began collecting maternal birth records that included body mass index data and maternal diabetes. Out of 14.1 million live births in the US, 81% occurred in women age 20-34, and heart health appears to decline in with age.
Poor heart health is driving up costs, in part, because it increases risk of costly conditions. For example, women with high blood pressure, obesity, and poorly managed blood sugar are at very high risk for heart disease later in life, but also face high risks of preeclampsia should they become pregnant. The hardening of the blood vessels and preeclampsia share the same common risk factor of vascular inflammation.
Preeclampsia affects about 5% of all inpatient deliveries and is characterized by high blood pressure and excess protein in the urine. Delivery is the treatment, and women with preeclampsia have 70% longer hospital stays. This correlates to much higher risk of maternal and fetal death as well as higher healthcare costs.
If delivery is the treatment, then women are fine after delivery, right? Not exactly. We often think of preeclampsia as temporary, but it has negative long-term effects that remain after delivery. Preeclampsia may accelerate cardiovascular disease risk factors in ways that do not completely reverse after the baby is delivered.
A 2020 study in the Journal of the American Heart Association assessed the health of US pregnant women. They found that:
Healthier pregnancies are important to support, but starting with healthier employees may be the best approach. This doesn’t mean hiring based on health. Instead, improving the health of those who are already part of your organization. Pregnancy increases motivation in many women to live healthier. This period is also a time of higher stress and greater fatigue for some women. Therefore it is ideal to start with healthier habits during the family planning stage, when the body is not going through so many changes.
At the same time, having policies that support pregnancy and new mothers can help to reduce the stress associated with this life change. An example of this is clear from the breastfeeding research. In the US, we have one of the lowest breastfeeding rates of any industrialized country, and this may reflect lower maternal leave times. It also reflects lower breastfeeding support and acceptance at the jobsite. Workplaces that have better breastfeeding support, which includes time to express milk, also have higher job satisfaction.
Regular reminders to employees about health benefits and related initiatives can help keep these options top-of-mind. It also underscores the idea that your leadership values their health, that they truly care about helping them build resilience.
As Treo’s Global Wellness Researcher, Karlie uses recent research findings to support healthier daily habits. Karlie earned her doctorate in Neuroscience and Behavior and bachelors in Health and Exercise Science.
© 2024 Treo Wellness.
