Maternal deaths are high in the United States, but there are ways to prevent deaths related to pregnancy. By understanding potentially life-threatening warning signs, Head Start staff can better support pregnant and postpartum women and people to have healthier and safer outcomes during pregnancy and the postpartum period.
In addition to supporting expectant families enrolled in the program, Head Start staff often interact with pregnant and postpartum women and people who have children enrolled in the program but are not enrolled as participants themselves. Staff who can recognize potential warning signs — including health managers, directors, home visitors, and family engagement staff — can help improve birth outcomes by assisting families in connecting to care.
Note: This document uses the term "pregnant and postpartum women and people" to refer to anyone who gives birth, regardless of their gender identity, which may be female, male, nonbinary, or other. For more information about inclusive language, read Exploring a Nonbinary Approach to Health.
Tips to Improve Services for Expectant Families
Maternal deaths can occur during pregnancy or anytime up to a year after delivery. Receiving care late in a pregnancy or not receiving any pregnancy-related care can increase the risk of complications.
For all pregnant and postpartum women and people:
- Ask how they are feeling and if they have any concerns about their pregnancy, recovery, or new baby.
- Listen to their concerns and share information with them about warning signs that something might be wrong.
- Confirm they are receiving medical care before, during, and after pregnancy.
- Find out if they have transportation to medical appointments.
- Offer to make phone calls to schedule appointments or arrange for transportation services.
- Share resources with them and their loved ones so they have the tools to advocate for healthy pregnancy and birth outcomes.
- Ask if they feel their health care provider offers culturally appropriate care and if they have had positive experiences with the provider.
- Help them get the medical care they deserve by connecting them to health care providers who provide culturally appropriate care and take their concerns seriously.
- Seek support from the program's infant and early childhood mental health consultant or help them obtain emergency care if they express thoughts about harming themselves or their child.
To develop services that meet the needs of expectant families you serve:
- Give opportunities for families who represent the communities you serve to help develop and review your policies and procedures.
- Include community members, obstetricians, midwives, doulas, and other providers on the Policy Council and Health Services Advisory Committee.
- Partner with the Health Services Advisory Committee on messaging and outreach to local health care providers and strengthen referral networks where needed.
- Review feedback from families to find out what is working well and identify opportunities to build and strengthen partnerships.
Urgent Maternal Health Warning Signs
Certain warning signs and symptoms may indicate an urgent health problem during pregnancy or the year after delivery. If someone is experiencing any of these symptoms, help them get medical care immediately:
- Headache that won't go away or gets worse over time
- Dizziness or fainting
- Thoughts about harming themselves or their baby
- Changes in vision
- Fever of 100.4 degrees or higher
- Extreme swelling of hands or face
- Trouble breathing
- Chest pain or fast-beating heart
- Severe nausea and throwing up (not like morning sickness)
- Severe belly pain that doesn't go away
- Baby's movement stopping or slowing down during pregnancy
- Vaginal bleeding or fluid leaking during pregnancy
- Heavy vaginal bleeding or leaking fluid that smells bad after pregnancy
- Swelling, redness, or pain in the legs
- Overwhelming tiredness
This list does not cover every symptom that pregnant or postpartum women and people might have. If they feel like something just isn't right, help them connect with a health care provider or seek urgent care.
Health Discrimination Warning Signs
Some pregnant and postpartum women and people experience discrimination or racism from health care providers, which can result in a greater risk for pregnancy and postpartum complications. Watch for these signs of discrimination when speaking with pregnant and postpartum women and people about their health care:
- Cultural incompetence (e.g., lack of translator, lack of diversity in patient education materials)
- Inability to reach their provider or schedule timely appointments
- Negative experiences with a health provider, including:
- Stigmatizing language
- Dismissing concerns
- Lack of respect and shared decision-making
- Negative assumptions about patient adherence to treatment
- Inadequate pain management
- Delay in treatment
- Lack of follow-up with patient
- Required labs not ordered or delayed
- Inadequate discharge planning
- Inadequate prenatal and postpartum care coordination
Guide to Talking with Health Care Providers
Head Start staff can play an important role by listening carefully to the concerns of pregnant and postpartum women and people. If they tell you that their concerns have not been taken seriously, share this guide to help them talk with their health care provider.
In the event of an emergency, seek care immediately from the nearest urgent care or emergency services facility.
When calling or visiting a health care provider, say:
- “I am worried about my pregnancy. I am experiencing these symptoms.” Then, explain all your symptoms.
- “I am worried about how I have been feeling since giving birth. I'm experiencing these symptoms.” Then, explain all your symptoms.
Sample questions to ask:
- What could these symptoms mean?
- I need to speak to someone now. Can someone call me today?
- Is there a test that can rule out a serious problem?
- Should I go to an emergency room?
If they still don't feel heard or report they have had a negative interaction with a health care provider, help them find more responsive care. Here are some things to consider when you help pregnant and postpartum women and people look for alternate care.
- Do they take the family member's insurance?
- When do they offer appointments?
- What languages do the staff speak?
- Is their office on a local transportation route?
- Does the practice include doulas or midwives?
Visit the Hear Her Campaign from the Centers for Disease Control and Prevention. The Campaign has resources for pregnant and postpartum women and people, their family members, and health care providers including printable warning signs posters in many languages.
For programs serving Black or American Indian and Alaska Native families, it is important to understand pregnancy-related health disparities that may also affect their birth outcomes. See Pregnancy-Related Health Disparities for Black Families and Pregnancy-Related Health Disparities for American Indian and Alaska Native Families to learn more.
Resource Type: Publication
National Centers: Health, Behavioral Health, and Safety
Last Updated: February 13, 2024