A century ago, only half of mothers received a physician’s care during pregnancy and the majority of babies were born in the home. Obviously, medicine has changed significantly in 100 years. But, to put the timeframe into perspective, my own father — number 15 of 17 siblings — was born on the family farm in Kansas. Today, nearly all mothers receive prenatal care and deliver in a hospital.
Earlier this week, MHA and our stakeholder partners announced Missouri’s acceptance into the Alliance for Innovation on Maternal Health collaborative. MHA will be leading the AIM implementation, which includes evidence-driven approaches to improve maternal safety and outcomes, with the goal of eliminating preventable maternal mortality and severe morbidity. Missouri joins 27 states that participate in AIM. The remaining states have either submitted an application or notified AIM of an intent to apply.
As I was thinking about how to explain why this is so important, I came across a blog post titled, “What it was like being pregnant in 1915,” on the UnitedHealth Foundation’s America’s Health Rankings website. Here are a few observations from a noted physician quoted in the post.
- In 1915 in the U.S., 70 women died per 10,000 births, compared to about 1 in 10,000 today.
- The major causes of mothers’ death 100 years ago were [from] HIT — hemorrhage, or massive bleeding; infection, also called “childbed fever;” and toxemia, now known as preeclampsia, a condition of high blood pressure that often went undetected and untreated because of a lack of prenatal care.
Unfortunately, these events remain significant causes of maternal mortality today.
Between the early and late years of the 20th Century, many of the dangers associated with pregnancy and childbirth were mitigated. Unfortunately, maternal mortality hasn’t been eliminated in the U.S. Today, the nation’s rate exceeds that of most western and developed nations. Moreover, since 1987 the nation’s maternal mortality rate has more than doubled — from 7.2 to 18 per 100,000 deaths per live birth. Among the states, Missouri ranks 42nd for maternal mortality.
The AIM announcement is the most recent of several related to maternal mortality prevention efforts in Missouri. Clinicians and hospitals recently launched the Missouri Maternal-Child Learning and Action Network to serve as a clearinghouse for mother- and child-related quality and safety issues. The MC-LAN leverages best-practice champions, peer networks and collaborative learning to drive improved health outcomes. The program allows hospitals, birthing centers, clinicians and community partners to engage in specific quality improvement projects and with collaborative support networks.
In the months ahead, MHA’s quality improvement staff will be reaching out to deliver tools that can improve care and outcomes in the clinical environment. The Hospital Industry Data Institute will be supporting the effort with data collection and reporting.
As a stakeholder, we’ll be engaged through the MC-LAN with government and community partners — including the Missouri Department of Health and Senior Services, Missouri Department of Social Services’ MO HealthNet Division, March of Dimes, Missouri Section of ACOG and the Missouri Chapter of the American Academy of Pediatrics — to address externalities that can lead to poor outcomes. There’s much to be done and more hands makes for faster work.
Our goal should be to eliminate childbirth-related mortality and morbidity. After all, if it was safer to give birth in Missouri in the 1980s than it was in the 1920s, we should have better, not poorer, outcomes today.
At the same time, targeted efforts can help reduce or eliminate disparities. Today, African-American women have double the maternal mortality rate of other races, nationally — a startling 40 per 100,000.
This week’s announcement marks important progress in our efforts to reduce and eliminate maternal mortality and morbidity.
Send me an email to let me know what you're thinking.
Herb B. Kuhn
MHA President and CEO
In This Issue
Legislative Committee Expands Health Proposal
Spring Newsletters Posted To Quality Reporting Center
Menorah Medical Center Names Interim CEO
Menorah Medical Center Names Interim CEO
Staff Contact: Carol Boessen
Charles Laird, CEO of Menorah Medical Center in Overland Park, Kan., resigned effective April 26. He accepted the CEO position at St. David’s Medical Center in Austin, Texas. Laird had served as CEO since May 2015. Jeffrey Taylor, Chief Operating Officer, is serving as Interim CEO until a permanent replacement is named. A list of CEO changes is available online.
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April 29, 2019
FY 2020 IPPS And LTCH Proposed Rule Issue Brief Available
CMMI Issues 2018 Report To Congress
Brookings Forum On Funding To Address Social Determinants Of Health
CMS Proposes Ligature Risk Interpretive Guidelines
MHA Workplace Violence Prevention Workshops Open For Registration
CHA Announces New President And CEO
April 30, 2019
MHA And KHA Weigh In On Workplace Violence In Health Care
FRA Reauthorization Bills Advance
Legislators Approve Pediatric Medical Futility Proposal
Hospital Legislation Gets Senate Approval
AIM Collaborative Brings New Tools To Reduce Maternal Mortality In Missouri
CMS Announces Outreach And Education Session
May 1, 2019
Committee Advances Medicaid Managed Care Reform Bill
CMS Proposes Rule To Strengthen Oversight Of Accrediting Organizations
CMS Announces Preview Period For VBP FY 2020 HSRs
Landmark Hospital Of Columbia Names New CEO
May 2, 2019
State Legislators Approve Tort Reform Bills
Legislative Committee Advances Health Proposal
CMS Administrator Posts Blog About Recovery Audit Contractor Burden
MLN Connects Provider eNews Available
New Resources Available To Address The Opioid Crisis
CMS Releases QDM Version 5.5