By Khadeja Haye, MD MBA FACOG, National Medical Director, Acute Hospitalist Medicine, OB/GYN Hospitalist
The CDC recently released a report from their Maternal Mortality Review Committee (MMRC) highlighting maternal mortality data for 2017-2019. The review compiled data from 36 U.S. states, looking at the leading causes of pregnancy-related deaths. The report indicates that more than 80% of pregnancy-related deaths during that time period were preventable. Mental health conditions were found to be the leading cause of pregnancy-related deaths. However, the leading cause of death varied when data were analyzed by race and ethnicity.
The leading underlying causes of pregnancy-related death included:
- Mental health
- Hemorrhage
- Cardiac and coronary conditions
- Infection
- Thrombotic embolism
- Cardiomyopathy
- Hypertensive disorders
Alarming, but Not Unexpected Statistics
While these data are shocking, for clinicians who care for pregnant women, it is not surprising. I do think it is important to reflect on the fact that the leading cause of pregnancy-related deaths was mental health conditions, which include deaths related to substance misuse disorders. We have likely only scratched the surface of understanding the downstream impact of the pandemic across the span of healthcare, and mental health issues are no exception.
There is much to learn from this report that we as clinical leaders can use as a focus for current and future efforts to reduce the risk of pregnancy-related deaths in the U.S. We first have to acknowledge that maternal mortality is an important issue that represents a healthcare crisis. This report only helps to support what healthcare workers have known and why our efforts in addressing this issue are needed.
Disparities in Maternal Care
The solutions also need to focus on the disparities in outcomes for the underserved and underrepresented population to address prevention for all pregnant women. The CDC report noted that 31.4% of the pregnancy-related deaths were among non-Hispanic Black women, yet they only account for 14% of the reproductive-aged women in the country. This highlights the known fact that there are disparities in outcomes for pregnant Black women.
Addressing the systemic issues that contribute to these disparities is paramount to our success in reducing pregnancy-related deaths while ensuring that all pregnant women benefit from the same high-quality care. A standardized approach must be initiated in every clinic and every hospital that cares for pregnant women. While it may seem like a daunting task to get all clinicians, hospital systems and government agencies on board, it can be done. There is already great work being done by various national organizations to support clinician education and advocate for resources to combat these issues.
TeamHealth’s National Skills and Drills Program
I am proud of the work we, at TeamHealth, have done to address some of the leading causes of pregnancy-related deaths and bring awareness to healthcare disparities. As the data suggest, many of these pregnancy-related deaths are preventable; therefore, preparing our clinical teams is a key component. Our OB/GYN clinical leaders have collaborated in producing online educational content that all of our OB/GYN clinicians are required to complete on an annual basis. We also developed and implemented a National Skills and Drills program to enhance the knowledge base, teamwork and communication in every clinical setting.
Some of the educational topics that have been developed at TeamHealth include:
- Hypertension in pregnancy
- Obstetric emergencies
- Maternal hemorrhage
- Sepsis in pregnancy
- Health disparities in obstetric care
- Amniotic fluid embolism resulting in cardiac arrest
Improving Quality and Safety for Maternal Patients
We understand that promoting quality and safety while fostering an environment that emphasizes the need for culturally sensitive care will benefit all of our patients. Our goal is to standardize our approach to caring for our pregnant patients with the hope of reducing these outcomes and the disparities among our underserved population. I believe it is important, as clinicians and healthcare leaders, to be a part of the solution to this health crisis.
Learn more about our commitment to helping hospitals deliver higher-quality care for women.