We Need a Sickle Cell Solution for Expectant Moms

Recently the team at Maternova had an opportunity to chat with a wonderful RN right here in our home state. Conversation ranged from our local maternal health outcomes, to how far behind the USA is falling behind in improving care for expectant Moms.

One topic in the conversation that resonated deeply with us, was also one that until that moment, we hadn’t given much thought to. We’ll be interested in your thoughts on this topic, so email us anytime.

One of the most overlooked diseases that can gravely impact pregnancy is Sickle Cell Anemia. This devastating abnormality which drastically reduces both RBC and blood oxygen, isn’t a typical antenatal screening point. Surprisingly enough, popular opinion believes the SCD exists largely only in Africa. But that isn’t the entire truth. While the majority of those battling this crippling disease, the Latin population is also predisposed to its grip. Here in the USA, it’s guessed that up to 100,000 people are actively living with the disease. Some of them are women who are pregnant, or may have just given birth.

It was with utter shock horror that I listened to our advisor friend explain to us that the normal treatment protocol for sickle cell ‘flare ups’ (which are excruciating ) has been Hydroxyurea, a prescription medicine designed to increase oxygen/hemoglobin levels and reduce pain. There is only one small caveat. Hydroxyurea is not intended for use during pregnancy, as it can cause multiple problems for the fetus, including serious birth defects.

During pregnancy, a woman’s RBC level rises 400-500 mL to support the 40-50% increase in blood volume. For a woman with sickle cell disease, it is close to impossible to meet those necessary levels in order to avoid both a flare up, along with causing many ante-natal complications like pre-eclampsia, eclampsia, and stroke just to name a few.

The current solution for helping expectant mothers who also happen to have sickle cell disease is sadly opioid based. Pregnant women are given Oxycontin to manage their pain. While Oxycontin/Oxycodone are labeled as a ‘category B’ drug, making it safe for use during pregnancy, there may be larger issues at hand. Addiction born from a woman’s use during pregnancy, is a serious and dire crisis in our healthcare system. This blogger will hazard a guess that those prescribing the opioids are not screening for history of addiction in the family, along with a full prenatal depression/mental illness and emotional health screening. Women are being turned into addicts out of sheer laziness in not developing a non-narcotic pain management system. We are working at Maternova to change that.

photo credit: UN Photo, Timor l'este