Improving Maternal And Infant Health Requires A Communitywide Effort

JEFFERSON CITY, Mo. — Despite Missouri’s high rate of maternal mortality and pregnancy-related harm, progress is being made. A new report describes the efforts of stakeholders in both clinical and community settings across Missouri to improve evidence-based care and support during, after and between pregnancy to reduce harm.

“More than 80% of pregnancy-related deaths are preventable,” said Herb B. Kuhn, Missouri Hospital Association President and CEO. “However, the factors that lead to these deaths — and the associated behaviors and conditions that can produce long-term harm for mother and child — often are disconnected from the birth experience itself. Reducing harm requires a broader view, encompassing health maintenance and quality care improvement throughout pregnancy, and supporting mothers’ and children’s health after.”

According to recently released data from the Missouri Department of Health and Senior Services, mental health conditions are the leading cause of pregnancy-related deaths, surpassing 2017’s leading cause of death — cardiomyopathy. SUDs contributed to 54% of pregnancy-related and 43% of pregnancy-associated but not related deaths. Among pregnancy-related deaths, 82% were determined to be preventable through a wide variety of stakeholder actions. Importantly, the rate of death among Medicaid beneficiaries was four times greater than the rate among mothers with private insurance, while Black women are dying at a rate four times greater than white women in Missouri.

A woman’s childbearing years have great potential to impact long-term health outcomes. Factors such as birth spacing, weight gain and health status between pregnancies have implications for maternal and infant health in subsequent pregnancies. However, limited access to care for many women outside of pregnancy influences these outcomes and long-term health. In the clinical space, access to evidence-based care is essential to improving pregnancy outcomes and supporting women’s health status before, during and between pregnancies.

“The interconnected programs and services included in this update reflect the significant actions taken to improve maternal health and pregnancy-related outcomes,” Kuhn said. “Although we’re making progress toward a system that recognizes and addresses the root causes of maternal morbidity and mortality, much work remains to develop a system that delivers these supports broadly, equitably, and during and between pregnancies.”

The stories of action shared in this new report highlight how organizations and stakeholders across the state are working to address the significant root causes of maternal morbidity and mortality. The variety of supportive efforts taken individually are powerful and are making a difference. But it is the newly realized growth in collaboration, alignment and synergy across these groups to achieve a common goal of decreasing the number of mothers and infants dying in Missouri that is making the greatest impact.

“Success in reducing mother and infant harm must recognize that many social, demographic and behavioral influences contribute to maternal and child harm before, during and after pregnancy,” Kuhn said. “Health care providers have an important role in identifying these challenges and helping mitigate their influence on outcomes. However, the problems associated with maternal mortality are not limited to pregnancy-related care — they extend beyond to women’s health overall. As a result, success in reducing harm will require continued collaboration across health care and community-based systems that contribute to pre- and post-pregnancy wellness. This report defines progress toward that goal.”

# # #