The US has a problem. But Texas, specifically, has it the worst in the states.
The problem? Keep new moms alive.
Across the United States, maternal mortality — when a mother dies from pregnancy-related complications while pregnant or within 42 days of giving birth — jumped by 27 percent between 2000 and 2014, according to a 2016 study published in the medical journal Obstetrics and Gynecology.
But researchers were stunned by Texas, where the maternal mortality rate had apparently doubled between 2010 and 2012. That year, 148 women died as the state’s mortality rate hit its highest level since the Centers for Disease Control and Prevention started recordkeeping with its current disease codes in 1999.
So what is going on!?
Well, nation-wide, we fail at recognizing symptoms of HELLP and educating mothers about signs and symptoms. There seems to be more of a focus on the infant vs the mother.
But Texas? Texas declined to expand Medicaid under the ACA, which certainly has hurt lower income persons who don't normally qualify for Medicaid to follow up with pre and post natal appointments. But there's more to it then that.
The Texas Tribune has heard harrowing tales of mothers enduring medical nightmares: They bled out, had strokes and heart attacks, lost babies during delivery. Dozens of experts and advocates say maternal deaths are a symptom of a bigger problem: Too many Texas women — particularly low-income women — don’t have access to health insurance, birth control, mental health care, substance abuse treatment and other services that could help them become healthier before and after pregnancy.
Texas also cut Planned Parenthood services and claimed that other community resources would be available to do healthy women check ups and offer family planning services. Those other resources are thin or not available.
Statistically, they've found that black woman are the most likely to die. And with the data available, they aren't sure why.
Overall, black mothers are at the highest risk of dying as a result of pregnancy, according to the task force report: While they delivered only 11 percent of the babies in Texas from 2012 to 2015, they made up 20 percent of maternal deaths. White women delivered 34 percent of the state’s babies over the same period and accounted for 39 percent of deaths, while Hispanic women accounted for nearly 48 percent of the state’s births and 38 percent of deaths.
Even though Hispanic and black women have similar rates of chronic health issues like obesity, diabetes and heart disease, task force members and researchers say they can’t explain why Hispanic mothers are more likely to survive pregnancy complications.
There seems to be multiple issues and not a "single solution." I'm bitter, but I still feel if we had a NHS-like program we would have less maternal deaths.
One of the cases:
Spoiler: show
Other states have lowered their maternal mortality rates-like California. So what did Cali do right and will Texas follow?
California lowered its maternal mortality rate by 55 percent between 2006 and 2013.
California is one of 15 states that have adopted a national model for improving care for pregnant women through 10 “bundles” — collections of proven strategies hospitals use to prevent and manage pregnancy complications such as hemorrhaging and high blood pressure.
The state also launched a “Maternal Quality Care Collaborative” that brought state agencies, hospitals and professional health care associations together to prevent pregnancy complications and deaths. It’s seen whopping success with how hospitals now handle two potentially lethal conditions: pre-eclampsia and hemorrhaging during and after labor
Texas Department of State Health Services officials say the state is implementing two bundles: one for hemorrhaging and another for hypertension. They’re also working with other states to develop another bundle for opioid abuse.
Another issue? Many women aren't having post-partum visits or having a post-partum appointment around 6 weeks after baby. This can be deadly.
Postpartum care is arguably as important as prenatal care. Federal data shows that more than half of maternal deaths happen after a woman gives birth, most often caused by cardiovascular disease, infections and hemorrhages.
But the American College of Obstetricians and Gynecologists found in 2016 that as many as 40 percent of women didn’t get postpartum care.
“So many of our patients don't take care of themselves in the postpartum period because they are taking care of their newborn,” said Sean Blackwell, president-elect for the Society for Maternal Fetal Medicine and a doctor in Houston. “Mom will commonly skip her visits to take care of her babies. Or, she's taking care of her other kids and family, and sacrificing her own health, which is going wacky.”
A baby’s first pediatric visit usually takes place three to five days after birth, but a mother typically won’t see her doctor until four to six weeks after delivery, if at all — and serious complications often emerge in the first few days and weeks after delivery.
Insurance coverage also matters. For women who gave birth and paid out of pocket for care or didn’t specify how they paid, 27.7 percent didn’t show up for their postpartum visit, versus 16.6 percent of women covered by Medicaid, according to Monitoring System data.
As a result of this news article, the Texas Tribune has released a PDF for expectant mothers.
In the course of our months-long investigation into the high number of Texas women dying or
experiencing serious complications during and after pregnancy, The Texas Tribune found that prenatal
and postpartum care are key for helping expectant mothers have the healthiest pregnancy possible.
To help Texas women know what to ask their doctors when they become pregnant, we compiled the
questions below from interviews with women's health experts.
The Tribune is asking people to share the PDF in hopes that it may help women know what questions to ask during their appointments. The end goal, of course, is to save a life.