A new National Academies of Sciences, Engineering, and Medicine report warns that missed opportunities to prevent and treat heart-related conditions are contributing to pregnancy-related deaths in the U.S.—and Anna Maria Siega-Riz, professor and dean of the School of Public Health and Health Sciences, says the gaps in care are both urgent and fixable.

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Cardiovascular conditions remain a leading cause of pregnancy-related deaths, yet most preventive care is concentrated during pregnancy and immediately after delivery. The consensus study report shows more than three-quarters of these deaths could potentially be prevented with stronger, more consistent care before, during and after pregnancy.

“The report represents the current state of the evidence and provides practical solutions to improve the situation, as well as identifies areas of research needs to enhance the health of reproductive-aged women,” says Siega-Riz, a member of the committee that wrote the report. “Improving the lives of reproductive-aged women in the current climate is desperately needed; these efforts will reduce medical expenditures while enhancing the lives of future generations.”

The committee calls for stronger preventive care, improved follow-up after delivery and better coordination across a patient’s reproductive life. The report found that 57% of pregnancy-related deaths occur between seven days and one year postpartum, a period when patients are less likely to receive consistent follow-up care.

The report identifies two areas with enough evidence to support immediate changes in clinical practice. Treating chronic high blood pressure during pregnancy to a target below 140 over 90 reduces complications such as preeclampsia and preterm birth without harming fetal growth. In addition, expanding postpartum blood pressure monitoring, particularly through programs that combine at-home tracking with clinical follow-up, improves early detection and short-term control.

The study describes pregnancy as a critical window for identifying long-term cardiovascular risk. Conditions such as hypertension and gestational diabetes can signal elevated risk not only during pregnancy, but also in the months and years that follow.

To address gaps in care, the committee recommends improving coordination between obstetric, primary and specialty care providers, maintaining insurance coverage and expanding telehealth services. It also highlights barriers such as transportation, limited maternity leave, lack of childcare, work schedules and limited broadband access, which can interfere with follow-up care.

The report calls on federal and state agencies to support programs that reduce these barriers and strengthen continuity of care, particularly through community health centers and workforce development initiatives.

It also outlines areas for further research, including new models of coordinated cardio-obstetrics care, remote monitoring technologies and support services such as doulas and peer navigators.

The study was conducted by the Committee on Clinical Preventive Services for Addressing Cardiovascular Disease Risk to Reduce Pregnancy-Related Deaths Among Women and sponsored by the U.S. Department of Health and Human Services.