This article is more than 5 years old. Information may no longer be current.
Maternal mortality review bill awaits legislative action
The Preventing Maternal Deaths Act and Maternal Health Accountability Act — House and Senate bills with bipartisan support that would help establish maternal mortality review committees in all 50 states — await movement in Washington, the president of the American College of Obstetricians and Gynecologists told Healio Family Medicine.
“Maternal mortality review committees are a critical tool to review the detailed medical records of maternal deaths. Doing so helps us understand the causes, the contributing factors and preventability, and also identify local solutions to keep the number of maternal deaths as low as possible,” ACOG president Lisa Hollier, MD, said.
Some states already have maternal mortality review committees, Hollier said, but if the bill became law it would provide support to establish these committees in all states. She provided an example of what maternal mortality review committees have recommended in the past based on their findings.
Using data from the review committee that showed hemorrhage was a leading cause of mortality, California came up with best practices that help doctors, nurses, and other health care providers more rapidly identify problems with hemorrhage. California, in collaboration with the Alliance for Innovation on Maternal Health, implemented tools to promote readiness, promote recognition — that timely recognition of the problem — promote the response, and then look at reporting so it is a continuous cycle of improvement in performance,” she said.
CDC data indicate there were 7.2 deaths per 100,000 live births in 1987, a number that increased to a high of 17.8 deaths per 100,000 live births in 2009 and 2011. CVD, non-CVD, infection or sepsis, and hemorrhage, make up more than 50% of all maternal deaths, according to the CDC.
Although maternal death affects all races, the incidence is higher among black women, according to Nadia Hussain, the campaign director of maternal justice with MomsRising, a group that teaches about issues impact women’s health.
“Black women are more likely to die from pre-existing conditions, so maternal health issues disproportionally impact black women and are a serious concern,” she said in an interview.
“Black women are three to four times more likely to suffer maternal mortality than white women,” Hollier added.
According to the CDC, there were 43.5 deaths for each 100,000 live births among black women in the United States from 2011 to 2013. Conversely, there were 12.7 deaths per 100,000 deaths among white women, and 14.4 deaths per 100,000 live births for women of all other races during that same time period.
“These are the worst maternal death rates for any developed country in the world,” Hussain said.
Movement on the bill was uncertain at the time of this story’s posting, and both Hollier and Hussein encouraged medical professionals to contact their lawmakers to voice their support for the bills. In the meantime, both women said there are things primary care physicians and women’s health clinicians can do in the interim to cut down on maternal death.
“Doctors can contact their colleagues or their state department of health to see if their state has an existing maternal mortality review committee and see if they can be involved in that. They can also find out about safety practices, such as those implemented with AIM, that their hospital, clinic, or office might already be implementing and participate in those,” Hollier said.
“We would encourage these medical professionals to have an open dialogue with women, particularly black women, when it comes to addressing their health,” Hussain added. – by Janel Miller
References :
CDC.gov. Pregnancy Mortality Surveillance System. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html. Accessed July 12, 2018.
All Information (Except Text) for H.R.1318 - Preventing Maternal Deaths Act of 2017. https://www.congress.gov/bill/115th-congress/house-bill/1318/all-info. Accessed July 12, 2018.
Congress.gov. S.1112 - Maternal Health Accountability Act of 2017 https://www.congress.gov/bill/115th-congress/senate-bill/1112/cosponsors. Accessed July 12, 2018.
Disclosures: Hollier is president of the American College of Obstetricians and Gynecologists. Hussain is campaign director at MomsRising, a nonprofit organization that works on issues around maternal justice.