Bill directs state to study rising rate of maternal mortality in Pa.

In response to a rising call to reverse a stunning increase in the nation’s maternal mortality rate over the past two decades, the Pennsylvania House of Representatives on Tuesday unanimously approved a bill to create a panel that would better study pregnancy-related deaths.

The bill for the Maternal Mortality Review Committee was proposed by state Rep. Ryan Mackenzie, R-Lehigh, after a group of obstetricians and gynecologists from local hospitals presented him data that showed the country’s maternal death rate continues to rise while it has fallen in the rest of the developed world over

the past 30 years — and the rate has more than doubled in Pennsylvaniasince 1994.

“I told them, ‘It sounds like pretty staggering data,’” Mr. Mackenziesaid.

It was staggering enough that in a state House strongly divided along party lines, not one representative voted against it. Mr. Mackenzie said state Sen. Lisa Baker, RLuzerne County, who chairs the Senate’s Health and Human Services Committee, has agreed to take up the bill for what he hopes will be quick passage and approval earlynext year.

The vote comes a day before a panel of experts gathers in Pittsburgh to discuss the issue.

TheWomen’s Health Activist Movement Global (WHAMglobal) and an offshoot of the Jewish HealthcareFoundation of Pittsburgh on Wednesday will bring together researchers from the Magee-Womens Research Institute to talk about why so many women in Pennsylvania are dying because of pregnancy.

“The thing is, it’s not an over-and-done research question about what is causing this,” said Karen Feinstein, cofounder of WHAMglobal and president and CEO of the foundation, “especially because the U.S. is going the opposite way fromtherestoftheworld.”

“We really want to start a conversation,” Ms. Feinstein said about the panel, which begins at 6 p.m. at Contemporary Craft, 2100 Smallman St., inthe Strip District.

Over the past two years, several major studies confirmed the rise of maternal deaths in the U.S., and in the past year several major journalistic investigations broughtthat data to life. Those stories showed that even though minorities and low-income women continue to have higher maternal mortality rates, “this can happen to anyone,”Ms. Feinstein said.

The Jewish Healthcare Foundation hopes that its panel will help create some ideas for prevention that can beput into action. The foundation already is acting on one idea: Providing a $230,000 grant to the Allegheny Health Network’s Center for Inclusion Health to improve maternal health among three immigrantcommunities.

AHN will use the money to credential and train doulas — professionals who work with mothers before, during and for a short time after pregnancy to help ensure a woman’s health — to help improve maternal health in Pittsburgh’s Latino, Bhutanese and Somali communities.

Ms. Feinstein said the foundation hopes the results of the grant can be used to “institutionalize” that having doulas and community health workers assist pregnant women improves their health, and convince insurance companies — public and private — that they should reimburse health agenciesfortheservices.

“Our problem is that in the U.S. we don’t have obvious reimbursement streams” for their services, she said, and those professionals who insurance companies do reimburse — like obstetricians — “don’t have the opportunity to go into a home where you can learnso much.”

WHAMglobal supports the creation of the Maternal Mortality Review Committee in Pennsylvania, which Ms. Feinstein said “is a really big milestone.”

If approved, the committee would be made up of experts who would get a more accurate count of women who die within one year of the end of a pregnancy, determine the cause and come up with recommendations.

Currently, 32 states have similar committees up and running or in formation. One of those created in California more than a decade ago made recommendations that are credited with cutting the maternal death rate there in half between2006 and 2013.

“That showed we could really have an impact with a committee like this,” Mr. Mackenziesaid.

Since 1999 the Pennsylvania Department of Health has kept a count of maternal deaths, but the state looks only at the deaths of women that occur up to 42 days after the end of a pregnancy. Most states and the federal Centers for Disease Control and Prevention consider these deaths as occurring up to a year after pregnancy. The legislation that required the department to collect that data does not require it to use it to make recommendations on preventingthem.

But the data appears to greatlyundercountthenumber ofpregnancy-relateddeaths.

For example, a community maternal mortality review committee in Philadelphia in 2015 looked at maternal deaths that occurred within a year of the end of a woman’s pregnancy in the city between 2010 and 2012. The study found 19 pregnancy-related deaths in Philadelphiaduringthattime.

By comparison, the state’s data found just 14 — nearly a 30percent undercount.

“That’s part of the issue: The [current state] data is not transparent,” said Kate Dickerson, woman’s health specialistwith WHAMglobal.

Mr. Mackenzie agrees. The state’s data “is part of the reason why I believe we need the Maternal Mortality Review Committee,” he said. “I don’t think we have accurate numbers right now that reflect the situation.”

Ms. Feinstein said she believes that one of the factors that may be contributing to the steady increase in maternal mortality over time might be continued improvement in our ability to track the health of the unborn child with technology.

“Because of that, I don’t know to what extent we’ve lost focus on the mom and not thefetus,” she said.

State data show that over the past 20 years before 2014 — the last year the state had data — the maternal mortality rate steadily increased, while the infant and neonatal death ratessteadily fell.

Mr. Mackenzie is hoping that the data the Maternal Mortality Review Committee gathers could help Pennsylvaniado what California did and cutthe rate in half.

“Ifyou have an opportunity to prevent half of the maternal mortality deaths, we should acton it,” he said.