What is maternal sepsis and why are Black women twice as likely to develop it? Here's what you need to know.

Preeclampsia, excessive bleeding, blood clots and cardiac conditions are some of the most common health problems that contribute to maternal mortality rates in the U.S. However, other risks are not mentioned as frequently, such as maternal sepsis, which is a life-threatening infection. Globally, 10.7% percent of maternal deaths are a result of sepsis. The condition recently gained attention following the death of 40-year-old Krystal Anderson, a former Kansas City Chiefs cheerleader and software engineer. The day after having a stillbirth, Anderson developed a fever and then died from cardiac arrest caused by sepsis. She is far from alone. Black women are twice as likely to develop severe maternal sepsis compared to white women.

Here’s what you need to know about sepsis and why Black women have higher rates of this dangerous infection.

What are sepsis and septic shock?

Sepsis is the body’s extreme reaction to an infection, according to the Centers for Disease Control and Prevention (CDC). Bacterial infections are the most common cause of sepsis, according to the CDC. The signs of sepsis include an elevated heart rate or weak pulse, fever or chills, confusion or disorientation, shortness of breath, clammy skin and extreme pain or discomfort, according to the CDC. In most cases, it’s treated with antibiotics.

Septic shock is the last and most severe stage of sepsis. Dr. Kelly Elmore, ob-gyn and chief of staff at Viva Life Health Hub, tells Yahoo Life that septic shock happens when bacteria gets into the bloodstream, leading to dangerously low blood pressure, organ failure and increased risk of death.

Once sepsis is detected, it’s a race against the clock to stop the infection from worsening. “The window of intervention is often quite narrow, mostly because it can be tricky to identify shock in its early stages,” Dr. Nsisong Asanga, physician and field epidemiologist, tells Yahoo Life. “Each setting has its challenges but many times, maternal sepsis is diagnosed late and the facility is ill-prepared to handle it.”

Why do Black women have higher rates of sepsis?

Racial bias and inequities play a part. Research shows that there is “clear evidence of structural racism in sepsis care and outcomes” and that “disparities in sepsis recognition could lead to delayed treatment.”

Having health insurance and access to health care are also factors. Research shows that pregnancy-associated severe sepsis is more likely to occur not only in minority women but also in those lacking health insurance. A 2022 study found that Black women also had the least access to prenatal care throughout pregnancy, with smaller numbers receiving care in the first trimester compared to white women. Research shows that poor prenatal care is a risk factor for sepsis.

Black women are also more likely to receive insufficient health care, ultimately increasing the likelihood of an infection becoming more serious. Also, the possibility of developing infections, including sepsis, is higher in those who have had stillbirths, miscarriages and certain health conditions such as kidney failure, diabetes and obesity, all of which are more prevalent in Black communities.

What can be done to reduce the risk of sepsis in Black women?

Both doctors and patients can take several steps, including providing education and better access to health care — in particular, making sure prenatal and postpartum appointments are easily accessible to Black women.

In addition to appointments, patients need further education so they can recognize the symptoms of an infection and bring them to the attention of their health care providers. Patients can start by taking prenatal classes that go beyond pamphlets and provide detailed information about infections, suggests Elmore. Also, being aware of their vital signs prepregnancy, during pregnancy and postpartum can aid in the identification of infections. Changes in vitals, such as body temperature and heart rate, are usually among the first signs of maternal sepsis. However, it’s not uncommon for those signs to be dismissed because some of those changes are common in pregnancy and can mask early symptoms of sepsis.

Treating any new symptoms with urgency can make a difference in improving care throughout the pregnancy and postpartum phase. Most postpartum complications happen within the first two weeks of delivery. “One of the most important parts of patient advocacy is not waiting for that six-week checkup to address concerns,” says Elmore. Some infections can occur within the first 24 hours of delivery or after being sent home, she adds. If you can’t see your ob-gyn prior to your six-week checkup, follow up with a midwife, doula or your primary-care provider as soon as possible. In addition, experts recommend that providers keep up with certifications, lifesaving training courses and antibias training so they are fully attentive and receptive to the concerns of Black women.

Experts also recommend that Black expectant parents familiarize themselves with the nearest hospital emergency rooms and urgent care centers. Waiting until there’s a problem to find out which hospitals are in network or can cater to pregnant patients can cost valuable time in receiving the antibiotics needed for an infection or other emergency.

“Each setting has its challenges, but many times, maternal sepsis is diagnosed late and the facility is ill-prepared to handle it,” says Asanga. “Do they have everything they need on standby? Are they adequately staffed or does one nurse have to run around five critical cases?” For example, some urgent care centers don’t have an ultrasound machine and can’t treat maternal sepsis or pregnancy-related concerns beyond checking vitals.

What strides have been made?

Some progress has been made in an effort to reduce the rates of maternal sepsis. For example, there have been advancements with the California Maternal Quality Care Collaborative to improve the diagnosis and treatment of maternal sepsis, and a universal home care nurse program was introduced in New Jersey to help provide support to new parents and newborns, do health evaluations and screen for complications.

As Elmore points out: “Even with all the doom and gloom, a majority of Black women still have uncomplicated pregnancies and deliveries.”