Something Isn't Right: Maternal Mortality In The U.S.
Right before I had Jack, I was made aware of the fact that the maternal mortality rate in this country isn’t where it needs to be. In fact, it’s literally the worst in the developed world. That means out of all of the countries in the industrialized world, there is a bigger chance of death occurring during childbirth in the United States. FanTASTIC. I was about three weeks from the birth of my third son.
Recently, USA Today came out with an exposé on rising maternal death rates in this country, methods of keeping new mothers safe and the fact that, though hospitals know how to keep them safe, they simply aren’t doing it.
From 1990 to 2015, data collected concerning the maternal death rate per 100,000 births showed that most countries had declining mortality rates. All except the United States, which had risen. It’s not just in rural hospitals or community birth centers. It’s happening in hospitals big and small, metropolitan and rural.
The most common causes of maternal death have been hemorrhaging and untreated preeclampsia or high blood pressure. It’s been found that most hospitals do not have a way of accurately quantifying blood loss in the mother after birth, thus treatment is delayed causing a higher incidence of mortality. It’s also not commonly known that preeclampsia can develop during or shortly after birth, as well, and often goes undetected until it’s too late.
“What we know about those deaths is that most of them were absolutely preventable,” a source was quoted. “They were from causes that we could have done something about. We could have prevented it if we had recognized the emergency early on.”
One of the issues in U.S. hospitals is a lack of standardization of care. One hospital might check blood pressure every four hours, another every six, and another once a shift. There is also the unreliable visual quantification of blood loss.
In Britain, a standardization of maternal care has greatly impacted their maternal death rates. They have reduced preeclampsia related deaths to one in a million, literally. According to a report on NPR, from 2012-2014, they had only two deaths from preeclampsia compared to the U.S., which has 50-70 preeclampsia deaths per year.
In countries with publicly funded national healthcare systems, it is easier to enforce standardization practices.
These life-saving techniques adopted around the world have failed to penetrate the U.S. maternity scene. With the exception of California, there hasn’t been any standardization of care. Back in 2010, California started developing “tool kits” of childbirth safety practices to reduce death and injury. These were made up of policies and procedures that appeared to be saving mother’s lives.
Disconcertingly, they had statistics from many North and South Carolina hospitals, including Women’s Hospital in Greensboro, where I delivered three sons. Their statistics were no better than the country’s overall stats.
Women’s Hospital in Greensboro is one of the largest birthing hospitals in North Carolina. They deliver approximately 6,000 babies annually. According to its own monthly tallies, Women’s Hospital failed to provide timely care to 189 out of 219 mothers with high blood pressure issues from October 2015 through June 2016.
Cone Health (the operator of Women’s Hospital) excused these problems by saying that they had just begun training their staff to act quickly in cases of maternal high blood pressure. The federal quality program, which wasn’t mandatory but was recommended back in 2011, has caused the hospital to improve its previously dismal numbers. From June 2016 through April 2017, 84% of women with high blood pressure were properly treated. As a result, the numbers of strokes and seizures of mothers has gone down.
The Alliance for Innovation on Maternal Health was created by a coalition of leading medical societies. Their purpose was to systematize safety protocols and procedures that have been known to have a positive impact on maternal health. They created “safety bundles,” which detail these policies, safety equipment, treatment policies, training programs and internal reviews that hospitals should implement.
Hospitals that have adopted these practices have improved their mortality rates. It seems as though it should be common sense that all hospitals in our country adopt these safety practices and procedures. Unfortunately, without centralization of our healthcare, reform of these practices will require multiple entities to insist on change. Entities like hospital administrators, health insurers, malpractice lawyers, to name a few.
How many more mothers have to die in this, one of the wealthiest nations in the world? How many is too many before we enact some sort of reform? I think one. One preventable death is too many.
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