Solving the mystery of Colorado’s maternal mortality
Four days after the birth of my first child, I waited in a hospital ER for seven hours with soaring blood pressure readings.
The physician occasionally apologized for the wait but noted that they were in the business of saving lives, inferring that my case was not serious enough to warrant immediate attention. I was eventually diagnosed with severe preeclampsia, which is a known and significant cause of sudden deaths among new mothers.
I wasn’t an outlier. The United States is failing our pregnant women and new moms. American women today are 50 percent more likely to die due to pregnancy-related causes than our mothers were. We live in the only “developed” country experiencing a sharp rise in this rate, which includes deaths during pregnancy or up to one year after.
We have a shared responsibility to foster the human potential that lies within our mothers and children, which begins with having a more comprehensive and timely understanding why deaths among Colorado’s pregnant and postpartum population are increasing so dramatically.
Maternal death review committees are the best way to understand rates of maternal mortality and to identify interventions to prevent deaths and other adverse maternal health outcomes. These experts take a public health policy and systemlevel view of these tragedies. They translate data and research into populationlevel action.
The Colorado Department of Public Health and Environment has had a dedicated committee of volunteer professionals reviewing maternal deaths since 1993, but the committee and the department lack the funding and legal protections they need to fully examine deaths and to regularly provide recommendations to our legislature on how to stop them. This includes a ban on reviewing deaths for three years, so the experts can’t be subject to subpoena by litigators working on individual cases.
Years ago, when advocates pushed for authorizing our Maternal Mortality Review Committee, some legislators expressed concerns about the privacy of medical information about such a tragic and personal event. That’s why committee members will be trained in confidentiality procedures and follow all state and federal privacy laws. We need to empower this committee and provide resources to ensure participation by a diverse group of experts and community representatives from across Colorado.
This committee has the power to identify and intervene in sudden surges in maternal deaths, but it also has the potential to address some of our more fundamental and stubborn statistics. We know that maternal deaths impact our whole state, yet women in rural areas are more likely to die than those in our urban centers. We
also know that African American women are more likely to die than white women — even when education and income are held constant. We can create solutions to address these underlying issues, but we need to start with a foundation of solid data.
As maternal deaths mount across the country, states are taking action. Thirty-six states had their maternal mortality review processes authorized in statute going into 2018 and six more states and the District of Columbia passed laws last year.
State Reps. Janet Buckner, DAurora, and Lois Landgraf, RFountain, have introduced House Bill 1122 to strengthen the Mater- nal Mortality Review Committee in Colorado. The bill passed unanimously out of the House Public Health Care and Human Services Committee on Wednesday.
I realize now my story is one of privilege. I’ve heard stories from women who nearly died because they weren’t screened or treated for postpartum depression and anxiety. And I’ve heard from women of color who couldn’t get treated for preeclampsia even after being admitted to a hospital. One hemorrhaged for hours in an ER without treatment. Some of these women have lost their babies.
On behalf of all survivors, mothers themselves or the loved ones left behind, I urge you to call on your legislators to support strengthening Colorado’s Maternal Mortality Review Committee in 2019.