Although the U.S. has some of the most advanced medical technology, it has the highest rate of pregnancy-related deaths of any high-income nation—prompting a need for better data to help save women's lives, Mary-Ann Etiebet, MD, executive director of maternal health initiative Merck for Mothers, writes in a STAT op-ed.
A USA Today investigation found about 50,000 women are severely injured each year during childbirth in the U.S., and 700 mothers die. U.S. hospitals often skip essential safety practices to prevent these outcomes, the report found.
Six insights from the op-ed:
1. To prevent maternal deaths, several states are establishing review committees to look at each pregnancy-related death, identify trends and use the findings to change policy and clinical practice, Dr. Etiebet writes.
The Every Mother Initiative, with support from Merck for Mothers, helped 12 states improve their maternal mortality review committees and use their findings to prevent maternal deaths.
2. The review committees identified causes for each pregnancy-related death that included chronic disease, mental health issues, substance use and domestic violence.
3. "Findings from these states have shed much-needed light on why maternal deaths have more than doubled in the U.S. since 1990," Dr. Etiebet says. "Until recently, these tragic events have been shrouded in a cloak of invisibility because they were not properly accounted for: Death certificates do not always link these deaths to pregnancy and childbirth; underlying causes, like depression or substance abuse, are not always apparent; and, state by state, systems of reporting and recordkeeping are fragmented and inadequate."
4. Dr. Etiebet highlighted several examples of how the 12 states are working to prevent maternal deaths. Colorado, Delaware and Louisiana focused on issues related to mental health. Colorado, for example, developed resources to help identify pregnant women with depression or who are at risk for domestic violence.
Georgia, Missouri and North Carolina identified poor health before pregnancy to be a key problem, Dr. Etiebet says. New York, Ohio, North Carolina, Oklahoma and Utah are improving hospital training and protocols for handling obstetric emergencies such as post-partum hemorrhage and pre-eclampsia/eclampsia.
5. Additionally, maternal mortality review committees in more than 30 states and two cities are using the tools and information offered through the CDC's Review to Action to help review and prevent maternal deaths, Dr. Etiebet writes.
6. Dr. Etiebet says the U.S. needs a national report on pregnancy-related deaths to give a nationwide perspective on the issue and identify trends, and the states' findings should be shared nationally.
"We must make sure that what individual states are learning is shared nationally and translated into actions that can save lives," Dr. Etiebet writes. "Only then will the tide on maternal deaths start to turn."