Preventing Maternal Mortality | The More Information The Better

Ohio has the dubious distinction of having a maternal mortality rate that has risen since 2018.

Health advocates are trying to identify the causes of maternal mortality and to make connections between those causes and policies that can reduce the number of pregnancy-related deaths.

A new report from the Ohio State Department of Health presents their latest findings, which are for 2017-2018. Laura Hancock reports that there was a sharp increase from 2017-2018, with 34 more women dying in this time span a result of illnesses or accidents related to pregnancy than in 2015-2016. (72 in 2017-2018 and 38 in 1025-2016). Furthermore, the mortality rate for White women increased from 59% to 79%, while the rate for Black women decreased from 34% to 15%. For Hispanic women and other races, the rate diminished from 7% to 6%.

At first glance, these numbers may seem puzzling, but the cause of the bewilderment lies in the state’s decision to include, for the first time, mental health and addiction as a cause of maternal mortality. Hancock explains, “The surge is largely attributed to drug overdose deaths, which the state now considers when classifying whether a death is related to pregnancy.”

In the report, 34 of the 72 deaths that were reported were the result of “mental health and addiction.” The vast number (28 out of 32) of overdose deaths occurred post-partum; specifically, “43 days to one year after pregnancy.”

Meanwhile, women who died in pregnancy suffered from hemorrhaging, embolisms, amniotic fluid embolisms, and mental health and addiction issues. And women up to 6 weeks post-partum died from infections, embolisms, and mental health and addiction issues.

To create the report, a committee reviewed information from a variety of sources about deaths that occur during pregnancy and up to a year post-birth, to determine if they were pregnancy-related. Hancock explains that “the death has to be caused by ‘a pregnancy complication, a chain of events initiated by the pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy.’” It is a very time-consuming process, which explains why the reports lag so far behind. The goal is to glean information that can be used to raise awareness about the factors that cause maternal mortality and then work to identify preventative care.

There is some concern that this change in reporting has occurred in order to focus attention on the opioid crisis and divert funding for programs that help women of color like Village of Healing, Birthing Beautiful Communities, and Moms and Babies First. Furthermore, changing the information collected makes it harder to assess whether the interventions that have been designed to support pregnant women are working.

Nevertheless, as Carly Fiorina, former CEO of Hewlett-Packard, and former candidate for the Republican nomination for president, said, "The goal is to turn data into information, and information into insight." Given the indisputable rise in number of deaths from overdose, as well as the stigma that comes with having addiction issues that makes pregnant mothers reluctant to get care, this new category is an opportunity to help more women have a healthy pregnancy and delivery as well as a healthy baby. It makes good sense to develop interventions for women in this predicament. Medications like methadone and buprenorphine have been proven to improve the outcomes for pregnant women who are drug users, according to Dr. Stephen Patrick from Vanderbilt Center for Child Health Policy.

There are no easy answers to solving the puzzle of maternal mortality. With so many variables that impact women and put their health at risk, it is encouraging to see efforts to consider as many potential causes as possible. The more we know, the more we can do.

Meanwhile, at The Eisen Law Firm, we help patients who have been harmed unnecessarily. Don’t hesitate to contact us and schedule your free consultation. Call 216-287-0900 or contact us online today.