Research has emerged about the link between pregnancy complications and a higher risk of stroke, and a Wisconsin health expert suggested it is a risk which might be flying under the radar amid positive trends for other populations.

May is American Stroke Awareness Month, and it is also National Women's Health Week.

A study out this year noted women with two or more complicated pregnancies had double the risk for stroke before age 45.

Cassie Nankee, vascular neurologist at the University of Wisconsin School of Medicine and Public Health, said it shows while there has been brighter news on this front for the public, pregnant women are isolated.

"Even more striking is that the prevalence of maternal stroke is higher in the U.S. than in any other developed nation," Nankee pointed out. "I think that's where we're seeing a lot of this data coming out and really demonstrating this huge problem."

Nankee acknowledged prevention efforts, such as limiting tobacco use, have helped to reduce stroke rates more broadly, but added there are unique and traditional risk factors for pregnant women, including higher blood pressure rates, which still need to be monitored. She encouraged providers to offer plenty of support and education to patients about these risks.

Nankee, who is also an American Heart Association board member, said when interacting with new or expectant mothers, doctors should offer a safe space, allowing the patients to open up about their health.

"It's the responsibility of the providers to take the time to listen to their patients," Nankee emphasized. "Even if it seems like a relatively small concern, we need to validate these patients."

Nankee added most strokes occur in the postpartum period and policymakers could cover a lot of ground by extending Medicaid coverage to postnatal mothers.

"A lot of women are not even cleared to go back to regular activity and are oftentimes not even back to work in that period, and they lose their insurance coverage," Nankee noted. "This can be a really big problem with a significant impact on these women."

A bipartisan bill in the Wisconsin Legislature would extend coverage for up to a year. At the moment, Medicaid coverage runs for 60 days after a birth. It is unclear if the plan will be adopted in final budget talks.

Women college graduates are not sticking to traditional compatibility traits when choosing a husband, according to one study. Preferences are changing as economics play a larger role.

American Institute for Boys and Men data say female college graduates have difficulty finding equally-educated partners.

University of Indianapolis Sociology Professor Amanda Miller, PhD, said historically, college-educated women married within the same circles.

Instead of foregoing marriage entirely, Miller explained, more are deciding on "exogamy" - marrying outside their social group.

"They're dipping down into a group of men who do not have a college education, but who do make a good living financially," said Miller. "College-educated women - if they can't find a man who has a degree - they're marrying, for example, someone who's a general contractor and has his own business, or a union pipefitter who makes a really good living."

The study found that marriage rates for college-educated women remain stable, even as their primary partners -- college-educated men -- become scarce.

Only about 50% of college-educated women marry a man at the same education level, while roughly 25% marry someone without a college degree. Another 25% remain single.

According to the research site World Population Review, in Indiana 50% of men and almost 48% of women are married.

Miller said remaining single or having a baby out of wedlock no longer carries the stigma it has in previous generations.

She added that the "working class" often has conservative or very traditional family values, and most people's beliefs and behaviors don't always go together.

"So, if you ask people with a high school diploma or perhaps an associate's degree or some college, 'Is it okay to have a baby out of wedlock? Is it okay to get divorced? Is it okay to cohabit?'" said Miller, "their answer is often 'no.' The flip side happens when we talk to the college-educated - they don't actually do those things themselves."

Miller also noted a decrease in women out-earning or being more educated than their husbands.

She observed that as college-educated women choose to marry men without college degrees, fewer working-class men marry women of a similar background.

As Women's Health Month draws to a close, the focus in on the growing issue of alcohol misuse among women in Missouri and across the nation. Research shows between 2021 and 2022, more than 1 in 5 women ages 18 to 44 in Missouri said they drank heavily, meaning eight or more drinks a week. Medical data shows that heavy drinking raises the risks of organ damage, cancer and pregnancy complications.

Merna Eppick, sober for 37 years, founded the Simmering Center recovery housing in Branson to help others find the same freedom. But she emphasized that statistics on women and alcohol misuse may not tell the full story because many women suffer in silence.

"If you were to look at the complexion of recovery opportunities, whether you go into a 12-step meeting, a treatment center, recovery housing, it's usually somewhere between a quarter and a third women and two thirds men, or three quarters men," she said.

Research shows women face greater social fallout, broken relationships and stigma from alcohol misuse. Eppick said there is help through peer respite support - community-based care for those in crisis.

According to statistics, alcohol misuse also puts women at higher risk for violence, car crashes and job loss. Almost 40 people in the United States die every day from alcohol-related crashes alone.

Dr. Lisa Saul, chief medical officer with UnitedHealthcare, noted that alcohol is deeply embedded in our culture, shaping how we socialize and view drinking.

"We are currently in a season of celebrations, the weddings and graduations and things of that nature - and it's become more and more of a cultural norm," she explained.

While the pandemic amplified alcohol misuse among women, the trend dates back to at least 2019, when 32% of high school girls reported drinking, compared with 26% of boys.

Sunday is Mother's Day, and what moms may need most is a day off.

Research shows that inequities persist in the amount of time moms and dads spend on child care. In 2023, American mothers spent on average 167% more time on primary caregiving than fathers. And the Institute for Women's Policy Research says that costs a mom nearly $17,000 per year - and $450 billion nationwide - in "foregone" income.

Kate Bahn, the institute's chief economist and senior vice president for research, said the trend continues with "secondary child care," or supervising children while multitasking - mothers spend 133% more time doing so than fathers.

"That is not time you can go into an office. That is not time where you can be out of the house," she said. "And so, that is time where you also still can't work for earnings. Some mothers are really constrained by their disproportionate caregiving responsibility."

Data show that in Montana, mothers make 59% of what fathers make per year - a difference of nearly $25,000. The inequities are worse among Native American moms in the state, whose pay is about half the earnings of white fathers.

Bahn added that rural families may face extra barriers.

"If we're thinking about all the constraints that shape how women decide to engage in the labor market," she said, "it can be things like driving distance to a job, access to child-care services for your children."

A bill to help support child-care workers in Montana passed both chambers of the state Legislature and could get to the governor's desk. It would expand eligibility for the "Best Beginnings Child Care Scholarship Program" to include child care workers - who are some of the state's lowest-paid workers.


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