The Gift of Blood: Preventing Maternal Death in Sickle Cell Disease

About one-third of all maternal deaths are caused by postpartum hemorrhage—severe bleeding after childbirth—which remains a global health issue.^1,2 Women with sickle cell disease (SCD) face even greater risks during pregnancy and childbirth.  Their condition can lead to serious complications like chronic anemia and painful blockages in blood vessels, making them more vulnerable to blood loss and other problems. Even with better medical care, postpartum hemorrhage is still dangerous, especially for women with health conditions like SCD that increase the risk of severe anemia.  For these women, pregnancy is a high-risk period, with greater chances of complications for both mother and baby.³

SCD affects the body by reducing oxygen in red blood cells. This added physiologic stress often requires (prophylactic) transfusions during pregnancy, delivery, and postpartum period to lower the risk of premature birth, reduce newborn deaths, and improve survival for both mother and child.⁴ Unfortunately, many healthcare systems lack sufficient blood supplies for these patients, raising the risk of maternal death.  One simple way to help is to donate blood. Your donation could save a mother’s life.

To improve outcomes, we need more than just good medical care.  Strong policies on blood donation and maternal health can make a difference. However, many policies still overlook chronic conditions like SCD, even though they are linked to higher rates of death after childbirth. It is critical that maternal health policies include the specific needs of women with SCD.

Several laws and programs work to improve maternal health overall, especially for vulnerable groups, and they include:

• The California Dignity in Pregnancy and Childbirth Act of 2019, which requires training to reduce racial bias in maternal care.⁵
• The Black Maternal Health Momnibus Act of 2021, which focuses on improving care for minority women and addressing social factors that affect health.⁶
• The Preventing Maternal Deaths Act of 2023, which works to reduce health disparities and improve maternal survival.⁷

To truly support women with SCD and reduce maternal deaths, we need a team approach that connects health care providers, hospitals, and policymakers.  Everyone has a role to play.

Author bio: 

Ja’Nece J. Dickerson, PhD, LCSW
Dr. Dickerson is an Assistant Clinical Professor in the Department of Interdisciplinary Studies within the School of Behavioral Health. Her research focuses primarily on Sickle Cell Disease, with a particular emphasis on identifying and addressing health disparities within this population.  Her broader research interests include the intersection of mental health and health inequities.  In addition to her academic role, she is a Licensed Clinical Social Worker and serves as a therapist at Daybreak Health, providing therapeutic services to children and teens in California school districts.  Previously, Dr. Dickerson served as the Program Manager for the Comprehensive Adult Sickle Cell Center at Loma Linda University Medical Center, where she led initiatives to improve the quality of care and patient outcomes.

Lisa R. Roberts, DrPH, MSN, FNP-BC, FAAN, FAANP

Dr. Roberts is a Professor and the Research Director at the School of Nursing, with a secondary appointment in the Division of Interdisciplinary Studies in the School of Behavioral Health.  She is a Fellow of the American Association of Nurse Practitioners and the American Academy of Nursing.  Her primary research interest concerns maternal health and sickle cell disease. Her research interests also include mixed methods and community-based self-help interventions, addressing issues impacting health disparities and vulnerable populations. Her clinical focus as a Family Nurse Practitioner is prevention and primary care.

GRANT SUPPORT:  1) Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UR6MC50347‐01‐00 Maternal Health Research Network (MH‐RN) for MSIs‐‐Research Awards to LOMA LINDA UNIVERSITY, Loma Linda, California.

References:

1. Henriquez, D. D., Bloemenkamp, K. W., & van der Bom, J. G. (2018). Management of postpartum hemorrhage: how to improve maternal outcomes? Journal of Thrombosis and Haemostasis, 16(8), 1523-1534. DOI: 10.1111/jth.14200
2. Sharma, D., Ogbenna, A. A., Kassim, A., & Andrews, J. (2020). Transfusion support in patients with sickle cell disease. In Seminars in Hematology (Vol. 57, No. 2, pp. 39-50). WB Saunders. https://doi.org/10.1053/j.seminhematol.2020.07.007
3. Sharif, J., Byrd, L., Stevenson, K., Raddats, J., Morsman, E., & Ryan, K. (2018). Transfusion for sickle cell disease in pregnancy: a single‐centre survey. Transfusion Medicine, 28(3), 231-235. https://doi.org/10.1111/tme.12447
4. Malinowski, A. K., Shehata, N., D’Souza, R., Kuo, K. H., Ward, R., Shah, P. S., & Murphy, K. (2015). Prophylactic transfusion for pregnant women with sickle cell disease: a systematic review and meta-analysis. Blood, The Journal of the American Society of Hematology, 126(21), 2424-2435. DOI 10.1182/blood-2015-06649319.
5. California Department of Justice, Office of the Attorney General. (2025). California Dignity in Pregnancy and Childbirth Act (AB 2319). https://oag.ca.gov/health-care/ab2319
6. U.S. House of Representatives. (2021). H.R. 959 – Black Maternal Health Momnibus Act of 2021 (117th Cong.). Congress.gov. https://www.congress.gov/bill/117th-congress/house-bill/959
7. U.S. House of Representatives. (2023). H.R. 3838 – Preventing Maternal Deaths Reauthorization Act of 2023 (118th Cong.). Congress.gov. https://www.congress.gov/bill/118th-congress/house-bill/3838.