Bundled up to break the wind off the water, I stared down at the small, timeworn gravestones marked not by years of birth and death, but by days and weeks.

Mary – stillborn, Stephen – 1 week, Sarah – 5 months and 12 days, Albert Henry – 6 years, 9 months, and 11 days, Louisa – 10 years, W.T. – 22 years

The cemetery sat on a knoll a short walk from Wades Point Inn on the Chesapeake Bay where I was staying for the weekend. All were the children of John W. and Sallie Kemp, owners of the property originally given to Zachary Wade as a 400-acre land grant in 1658.

Sallie Kemp buried at least five children and one young adult. She was 23 when she had Mary in 1837 (the year Queen Victoria took the throne) and 44 when she had Albert Henry in 1858 (the year Lincoln launched the Republican Party). That means for at least 21 years, Sallie was pregnant, birthing children, raising children, and burying children. Add to the tally were several miscarriages for sure.

It was Mother’s Day weekend when I found the cemetery.

Bearing children was a public health risk for both mothers and infants through most of the 1800’s and first half of the 1900’s. The CDC considers family planning and access to contraception (introduced in the 1960’s) one of the top ten most important public health advancements of the 20th century, contributing to the increase in longevity by 30 years.

Alarmingly, however, the trend in pregnancy-related deaths is increasing again. The US is the only industrialized nation with a rising maternal mortality rate, and between 2000 and 2014, there was a 26% increase in the maternal mortality rate.[i] According to the American College of Obstetricians and Gynecologists (ACOG), cardiovascular disease is now the leading cause of death in pregnancy and the postpartum period. It constitutes 26.5% of pregnancy-related deaths, with higher rates of mortality among women of color and women with lower incomes.[ii] Rates for black women are astonishingly 3.4 times higher than that of white women.

Recently, ACOG released a comprehensive guidance on pregnancy and heart disease calling for routine screening for cardiovascular disease for women pre- and post-delivery.

Sallie did not have access to the technology and services available to women today. Raising awareness of the ACOG guidelines, especially among women with heart disease or at known risk of heart disease, will hopefully help deliver healthy babies to healthy moms.

[i] MacDorman, M., Declercq, E., Cabral, H., Morton, C., “Is the United States Maternal Mortality Rate Increasing? Disentangling trends from measurement issues: Short title: U.S. Maternal Mortality Trends.” Obstet Gynecol. 2016 Sep; 128(3):447-55.

[ii] https://www.acog.org/About-ACOG/News-Room/News-Releases/2019/ACOG-Releases-Comprehensive-Guidance-on-How-to-Treat-Heart-Disease-in-Pregnancy?IsMobileSet=false