Health Officials Combat Nation’s Maternal Mortality Rates

May 08, 2019

ARLINGTON, VA—State and territorial health officials are assessing maternal care programs within their states to address the rise in maternal deaths across the nation. According to a new Centers for Disease Control and Prevention (CDC) Vital Signs report, each year more than 700 women in the United States die during pregnancy, delivery, or up to a year postpartum, with three out of every five of these deaths being preventable.

The Association of State and Territorial Health Officials (ASTHO) and its members are committed to protecting the health of mothers through multidisciplinary efforts to address preventable deaths, such as closing gaps in access to quality preconception and prenatal care, care for chronic conditions, missed diagnoses, and maternal education.

“Across the country, state and territorial health officials are continually analyzing women’s health data, programs, and outcomes to address and prevent maternal mortality and morbidity,” says Michael Fraser, CEO of ASTHO. “As with all public health issues, officials take this trend very seriously, and we know that tackling this issue involves addressing the unique social, economic, and healthcare challenges that impact women’s health on multiple levels in every state.”

The causes of maternal mortality and morbidity vary widely, depending on many local factors and stage of pregnancy or post-pregnancy. For example, weakened heart muscles (cardiomyopathy) are the leading cause of death between one week and one year postpartum. Postpartum care, however, often focuses on the infant—not the mother. Providing and covering high-quality care for mothers the first year following birth would ensure prompt follow-up care and communication about issues like severe bleeding, high blood pressure, and infection.

“The majority of deaths from pregnancy-related complications are absolutely preventable,” says Nicole Alexander-Scott, MD, MPH, director of the Rhode Island Department of Health and president of ASTHO. “We also know that significant racial and ethnic disparities exist in the rates of fatalities from pregnancy-related complications. Health systems, healthcare providers, and public health professionals need to continue taking measures to improve access to and coordination and delivery of quality care for all women, regardless of their ZIP code. We also need to engage patients and communities in this work so that everyone knows that their voice matters, and that they are being heard.”

Many states are assessing maternal and perinatal levels of care and the standardized capabilities of individual hospitals to ensure pregnant women deliver at facilities equipped for a range of medical outcomes. Some of these efforts include:

• Indiana passed a perinatal levels of care law (SB 360) last year so the state health department could establish a program to certify perinatal levels of care designations for licensed hospitals and birthing centers. The Indiana State Department of Health also works alongside the Indiana Hospital Association, the Indiana Rural Health Association, and the Indiana Family and Social Services Administration’s Office of Medicaid Policy and Planning to investigate opportunities to keep rural hospitals and obstetric units open, as 35 of Indiana’s 92 counties either have no hospital or have a hospital without obstetric services.
• The Texas Department of State Health Services (DSHS) established a multidisciplinary Maternal Mortality and Morbidity Task Force to review cases of pregnancy-related deaths and severe maternal morbidity, identify trends and disparities, examine best practices, and make recommendations to reduce the incidence of pregnancy-related deaths and severe maternal morbidity. Additionally, Texas DSHS is leading the statewide TexasAIM initiative to help hospitals and clinics in Texas carry out maternal safety projects.
• The North Carolina Maternal Mortality Review Committee identified significant racial disparities in maternal deaths, causing the state to place a greater emphasis on addressing the non-medical issues responsible for exacerbating these disparities. These efforts led to a reduction in disparities in pregnancy-related deaths over a 10-year period. North Carolina continues to work to confront the remaining increased risk of pregnancy-related deaths among black women.

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ASTHO is the national nonprofit organization representing the public health agencies of the United States, the U.S. territories and freely associated states, and Washington, D.C., as well as the more than 100,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and to ensuring excellence in public health practice.