Maternal deaths on the rise

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JANS – The Mississippi Maternal Mortality Review Committee (MMRC) has released a report on deaths from 2016 through 2020. The independent group, established in 2017, reviews maternal deaths to find opportunities for improvement and make recommendations to prevent future deaths in the state. 

Some startling statistics include 80 percent of pregnancy-related deaths in Mississippi were deemed preventable, and 92 percent had some level of opportunity to alter the final outcome (death). 

“This report shows that in 2020, Black, non-Hispanic women had a pregnancy-related mortality rate that is four times higher than white, non-Hispanic women. That’s why the Healthy Moms, Healthy Babies program at MSDH is our top [priority]. We offer care management and home visits for expectant moms and infants at risk for health problems. Losing one mother is too many,” said Dr. Daniel Edney, State Health Officer, Mississippi State Department of Health (MSDH). 

The death investigations are a stark reminder of the challenges that pregnant women face in Mississippi. 

According to the report, cardiovascular disease and hypertension are the top contributors to maternal mortality, but it “also illuminates a troubling trend of pregnancy-associated death related to mental illness, substance abuse, homicide, and suicide. It is imperative to ensure timely identification, referral, and treatment for those with mental health needs. Thoughtful integrative strategies to lower the burden of mental health, substance abuse, and gun violence will be key to reducing to maternal death from these causes.” 

Nationally, the maternal mortality rate has been increasing as well. In 2020, it rose to 23.8, and in 2021 to 32.9 per 100,000 live births. 

Mississippi numbers from 2016-2020 

• The pregnancy-related mortality rate was highest (81.5 per 100,000 live births) in women within the 35-39 age group. 

• The majority (43%) of pregnancy-related deaths occurred in women who were pregnant 43 days up to one year post pregnancy and before death. 

“I am grateful to the leadership and volunteer members of the MMRC who tirelessly leave no question unasked and no stone unturned in exploring what happened and how these deaths might have been prevented. When we know better, we can do better,” said Dr. Edney. 

“We continue our call to action for all elected leaders, healthcare leaders, stakeholders, and community partners to join MSDH in this effort to not only reduce, but minimize maternal infant deaths in Mississippi,” Dr. Edney said. 

Committee recommendations include: 

• Medicaid expansion should be incorporated for rural hospitals to remain open and include access to telehealth services. There is a need for rural healthcare facilities to provide higher levels of critical care, recruit and retain adequate providers, and have access to life saving equipment, especially in the most vulnerable areas of the state. 

• Improve utilization of telehealth services in rural areas for pregnant women and families to easily access maternal and fetal medicine specialists. 

• There should be communication between all providers caring for the same patient during the same time period. Mental health providers should be included in the communication loop (if applicable) and equipped to handle all referrals from other providers. 

• All healthcare providers should have knowledge and/or education regarding urgent maternal warning signs. 

• Women should have adequate paid maternity leave to allow for the appropriate amount of recovery time needed before returning to work after giving birth. 

• Patients and their families should be educated on maternal early warning signs. 

Note: The MMRC was developed with guidance from the Centers for Disease Control and Prevention’s (CDC) Division of Reproductive Health and modeled after well-established review committees in the United States. The committee includes representation from a broad range of physicians and nurses from multiple specialties (obstetrics and gynecology, cardiology, pulmonary medicine, anesthesiology, maternal-fetal medicine, public health), community leaders, and other health/safety-related professionals who extensively review maternal deaths to identify opportunities for prevention. MSDH does not influence or alter recommendations. 

To see the full Mississippi Maternal Mortality Review Committee report, visit https://msdh.ms.gov/maternalmortality.

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Maternal deaths on the rise

By Jackson Advocate News Service
December 18, 2023