Cook County resident Maylene Pena, a 40-year-old mother of three, nearly lost her life due to childbirth complications with her second child, and endured pregnancy related complications with all three children.

She submitted her story as written testimony for a hearing being convened by Cook County Commissioner Donna Miller Tuesday that will examine maternal death rates, which have worsened nationally and continue to be higher for Black and Hispanic women.

Maternal death rates in the U.S. increased nearly 60% in 2021 from 2019, according to data from the National Vital Statistics System released earlier this year by the U.S. Centers for Disease Control and Prevention. The rate among all women was 32.9 deaths per 100,000 live births in 2021, up from a rate of 20.1 deaths in 2019. Among Black women, the rate was more than two times that at 69.9 deaths in 2021, up from 44. Among Hispanic women, the rate more than doubled to 28 deaths up from 12.6.

In suburban Cook County, the pregnancy-related death rate was 2.6 times higher among Black women than white women from 2015 to 2019 and was the highest in the south and southwestern suburbs and among mothers under 25 years of age, according to the Cook County Department of Public Health.

Pena, who calls herself a first-generation Afro-Latina, said she endured excruciating pain and literally felt the surgeon’s scalpel pierce seven layers of her tissue during an emergency C-section performed to save the life of her first child. Her pleas that she could feel the pain were ignored and the procedure left her with a keloid that led to complications following the birth of her second child, she said.

After delivering her second child, she said her concerns about unusual pain were again ignored, and she ultimately ended up nearly bleeding to death when her placenta swelled and severely hemorrhaged. It took six doses of anticoagulant to stop the bleeding, said Pena, who is an entrepreneur and Miller’s executive assistant.

Following her pregnancies she suffered from depression, anxiety, chronic pain and post-traumatic stress disorder, she said.

It’s important to “shine light on the disparities that Black and brown women face to bring forth some solutions to this ongoing problem,” said Pena.

Health care professionals need to listen to their patients and respond to prevent deaths and complications, she said.

“I’m focused on how we can improve health outcomes across Cook County,” said Miller of what drove her to convene the hearing.

The hearing will also examine how to reduce pregnancy or delivery complications that can have short-term and long-term negative affects on women’s health.

“We know the data,” and it cuts across income levels, so the problem is not just one of social determinants of health issues, she said. “We need to have a plan, a huge education effort for women. We want to arm them with information, so when they see something happening, they can ask questions. I hope that’s something that comes from the hearing.”

Roughly a dozen speakers are expected. Among them will be U.S. Rep. Robin Kelly, D-Matteson, who has introduced maternal health-related legislation and with whom Miller has worked with on the issue.

“The numbers are going the wrong way,” Kelly said. “Maternal mortality is a public health crisis that has to be addressed at every level.”

Kelly, who chairs the Congressional Black Caucus Health Braintrust, fears the situation will only get worse in the aftermath of the U.S. Supreme Court decision a year ago stripping individuals of their constitutional right to an abortion with the reversal of Roe v. Wade.

“The more women are forced to have a baby, it stands to reason there will be more maternal deaths,” she said, as she noted there are continuing issues with access to quality maternal and women’s health care.

Sixty-eight percent of office-based obstetricians and gynecologists responding to a Kaiser Family Foundation survey released last week say the Supreme Court’s ruling worsened their ability to manage pregnancy-related emergencies, 64% said it worsened pregnancy-related mortality, 70% said it has made racial and ethnic inequities in maternal health worse and 55% said it has made it harder to attract new OB-GYNs to the field.

Improving maternal health requires an all hands on deck approach, including roles to be played by pregnant women and their families, health care providers and hospital systems, said Dr. LaMar Hasbrouck, chief operating officer of the Cook County Department of Public Health, who will speak at the hearing. For pregnant women and their families, it’s important they are connected to good quality care, aware of urgent warning signs and make providers aware if they are experiencing warning signs, Hasbrouck said.

He cited as examples prolonged headaches, the baby not moving as much as it did previously, fever, vision changes, vaginal bleeding, trouble breathing and severe stomach pain.

For health care providers, it’s incumbent upon them to manage other chronic medical conditions patients may have which sometimes can be worsened by pregnancy, such as high blood pressure, diabetes and depression, said Hasbrouck.

“They also have to be familiar with the warning signs, so they are asking about them and putting them in the right context,” he said.

Health care systems need to be aware of “unconscious bias and making sure you are treating every patient with due respect and diligence and not making assumptions,” he said.

Tackling maternal mortality and morbidity rates requires meeting patients where they are, said Dr. Nicole Williams, an obstetrician, gynecologist, and surgeon and legislative chair of the Cook County Physicians Association, an association of Black physicians.

“That means expanding telehealth services, well woman visits and the ability to do in-person care because health begins before pregnancy,” said Williams, who also is founder of Chicago-based The Gynecology Institute of Chicago Ltd.

Mental health services also must be expanded, she said.

“We talk about cardiac events, and hemorrhaging being risks for death, but there’s also the risk that postpartum depression can play.”

On the national front, among legislation Kelly has introduced in Congress to improve maternal health is the Mothers and Offspring Mortality & Morbidity Awareness Act. Kelly’s office said provisions that passed as part of the Fiscal Year 2022 omnibus legislation include:

• establishment of grant programs for health professionals to develop best practices and improve maternal mortality review committees

• funding for bias training for providers to prevent discrimination when providing maternal health services

• establishing rural obstetric networks

• making permanent the option for states to extend Medicaid coverage for new moms from 60 days after childbirth up to a year. Thirty-six states have officially extended so far.

Other provisions will be reintroduced this summer include provisions to enhance maternal workforce diversity, increase access to maternal mental health, making Medicaid expansion to one year postpartum mandatory for every state and standardizing data collection and reporting.

Francine Knowles is a freelance columnist for the Daily Southtown.