Maternal Death Rate Continues to Rise

The maternal mortality rate in the USA has made the news again, and for the usual reason.  It has continued to increase significantly during 2021. This really bothers me. The rate was double that of some European countries, and triple that of other European and Asian nations. We can wring our hands, finger point and blame it on Covid among other things but the sad fact is that the US has been and continues to do something wrong.

I've written about almost losing my sister after the birth of her son, and how that prompted me to become a midwife. The fact that nothing has changed, and has only gotten worse just breaks my heart.  The CDC has said up to 80% of maternal deaths could have been prevented. When Serena Williams had her baby, she had issues that would have been fatal if she had not been able to advocate strongly for herself, and what makes her story even more concerning is that she had a known history of blood clotting issues and she still wasn't taken seriously when she began experiencing symptoms.

There are many components to the maternal morbidity crisis. I have some ideas to reduce the impact of some of those components and in turn reduce the maternal morbidity rate.

• Listen to mothers, after all they are the ones who know their bodies the best.
• Take mothers' complaints seriously and don't ignore them.
• Have more frequent postpartum checkups.
• Give all postpartum parents paid time off with no exceptions.
• Provide postpartum doulas to help mothers in the first feew weeks after birth.
• Have more midwives. In states such as Kansas with large rural areas, having providers close by instead of expecting women to drive over an hour for care will make a huge difference in outcomes.
• CPM, CNM, MFM and OBs working together as a team so care can be provided by the appropriate provider and smoothly transitioned if something changes.
• Train and equip EMS to handle birth and newborn emergencies instead of hoping the emergency happens close enough to a children's hospital that they can send the ambulance.

These are things that need to be done at the local level and nationwide.  Some of these suggestions will take time to implement such as training more midwives. Some have already been recommended like more frequent postpartum checkups but have yet to be common practice at the local level, and in many areas across the country.  Some can be implemented pretty quickly such as training and equipping EMS and other emergency services for birth and newborn emergencies.  Even addressing one thing on my list will improve outcomes and change the maternal mortality trajectory. It's time to take action instead of sitting around bemoaning the fact that maternal deaths continue to rise in the USA.