07.19.21
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Although efforts to reduce maternal mortality and morbidity are growing, we’re making slow progress toward reversing what has been a trend line going the wrong direction. Two recent reports help explain where we are and where we’re headed.
Several weeks ago, the state issued the annual report on maternal mortality and morbidity. According to the Pregnancy-Associated Mortality Review report, mental health conditions are the leading cause of pregnancy-related deaths, surpassing 2017’s leading cause of death — cardiomyopathy. Substance use disorder 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.
Thursday, MHA released a report on the activities of health care and community stakeholders to mitigate the problem of maternal mortality and morbidity. Our report recognizes that stakeholder efforts must reach beyond pregnancy or the care environment — taking a broader view that encompasses health maintenance and quality care improvement — to support mothers’ health, before, during and after pregnancy.
Health equity is a significant challenge. Delivery of equitable care could help improve Missouri’s status. The rate of death among Medicaid beneficiaries was four times greater than the rate among mothers with private insurance. Black women are dying at a rate four times greater than white women in Missouri. Understanding how health equity interplays with mortality and morbidity is essential to reducing harm.
In the clinical environment, progress toward evidence-based care is essential to improving pregnancy outcomes and supporting women’s health status throughout.
The two reports complement one another. The PAMR report identifies and quantifies the problem. MHA’s report identifies the systems that are being put in place to mitigate harm.
This challenge can’t be viewed simply as a failure of the health care system to address maternal health. Solutions are both clinical and community-based, requiring collaboration, alignment and synergy to address the shared goal of decreasing the number of mothers and infants dying in Missouri.
As with many of the state’s health challenges, success will require action to address the many social, demographic and behavioral influences that contribute to maternal and child harm. Certainly, health care providers have an important role. However, better outcomes require better women’s health overall.
MHA’s report indicates that we are making important progress toward reducing harm and improving health. Results are a lagging indicator, but I am confident that our collective efforts in health care and with other stakeholders will begin to turn the tide through pre- and post-pregnancy wellness.
Send me an email to let me know what you are thinking.
Herb B. Kuhn
MHA President and CEO
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