12/15/20

What will it take to reverse the rising maternal mortality rate in the U.S.?

Even in developed countries like the United States, the maternal mortality rate is higher than it should be. In fact, the U.S. has the highest maternal mortality rate in the developed world.

With proper care before, during and after childbirth, many women’s lives can be saved. The state of California is one example where concerted efforts are being made to improve maternal mortality rates—and those efforts are working.

“California took this issue head on, which is admirable,” said Dr. Mark Simon, chief medical officer for OB Hospitalist Group. “They looked at their maternal mortality events and investigated them to find causes. Then they developed some very simple toolkits for hospitals to use around hemorrhage and high blood pressure during pregnancy, for instance.”

The last step in their process was to track data to find out how each hospital was doing when it came to providing care to obstetrical patients.

“Bottom line, they put a very focused effort on addressing the issue of maternal mortality and are actively managing it,” adds Dr. Simon.

Texas is another state taking steps to address its high rate of maternal mortality. One tactic they employed, in addition to distributing toolkits, was to designate which hospitals effectively care for patients with high-risk conditions.

“The goal is to try to get patients where they need to be for their treatment, so that hopefully the care they receive will prevent maternal mortality or morbidity,” notes Dr. Simon.

Causes of maternal mortality

One of the leading causes of maternal mortality is preexisting cardiovascular disease as patients with heart conditions can experience pregnancy complications. Other common diagnosis that can lead to maternal death is high blood pressure during a pregnancy, known as preeclampsia or eclampsia, and obstetrical hemorrhage.

“These issues can lead to maternal death as well as bleeding during pregnancy, but more commonly result in postpartum bleeding after the delivery,” explains Dr. Simon.

Dr. Simon urges hospitals to ensure their OB team is practicing the latest protocols so they can provide the right care for these high-risk situations.

OB hospitalists as physician champions

While the tide is changing when it comes to awareness and acknowledgement of maternal mortality, there is more to be done. Simply having a toolkit is not enough. Hospitals need participation from various stakeholders: hospitals, clinicians, patients and their families.

“You need nursing and physician champions,” said Dr. Simon. “That’s where OB hospitalists can certainly play a role. It’s one thing to have a toolkit that tells you how to approach a certain condition, but the most important step is implementing the toolkit. You have to have buy-in at the hospital level for the entire department to follow the guidelines.”

Clinicians and OB hospitalists can also create change by educating the general population.

“It is going to take the families and the patients themselves to advocate on their own behalf. It’s imperative that in an obstetrical situation where you feel like you are not being heard by the healthcare system to keep stating it. Shout until someone hears you. Advocate on your behalf,” urges Dr. Simon. “I have faith that the United States healthcare system can turn this around and we can make a huge impact on the lives of these women and their families.”

To listen to an interview on this topic with OBHG Chief Medical Officer Dr. Mark Simon, click here.