Lawmakers worried about rising national maternal mortality

It’s getting more deadly to have a baby in America than it used to be.

American mothers had a better chance of surviving for a year after giving birth 25 years ago than they do today.

That makes the nation’s survival rate for new mothers worse than some third-world countries and worse than any other developed country.

Worse, instead of getting better, the United States is one of 13 countries that have seen their rate of maternal mortality increase in the last few years.

From 1991 to 2014, the rate of mothers dying within a year after giving birth in the U.S. increased from 10.3 per 100,000 live births to 23.8 per 100,000 live births, according to the Harvard

Business Review.

And perhaps worse still, mothers of color are more than twice as likely to die within a year of childbirth as white mothers.

These disturbing statistics were revealed during a joint hearing by the Pennsylvania Senate and House Democratic policy committees on Aug. 12.

The hearing was at the request of state Sen. Judy Schwank, D- 11th Dist.; and state Reps. Mary Jo Daley, D-148th Dist. and Morgan Cephas D-192nd Dist.

“The increasing rates of maternal mortality in the United States were extremely concerning before the coronavirus pandemic hit, but as we continue to fight the spread of COVID-19, we need to make sure that we are continuing to work for policies that give new moms and babies the healthiest outcomes possible,” Schwank said.

“What’s most disturbing is how preventable so much of this is,” said state Sen. Lisa Boscola, D-18th Dist., who chairs the Senate Democratic Policy Committee.

“This is not just a woman’s issue, it affects whole families.”

“Pennsylvania has an alarming maternal morbidity rate, and the pandemic is highlighting the barriers and inequity in care,” said Daley, adding, “I am hopeful (the testimony) will transition to statewide policies.”

“What struck me most are the racial disparities,” said Daley. “Black women are more likely to suffer maternal mortality, and just think how that impacts a family.”

Race in Medicine

Race, poverty, limited access to healthcare, drug addiction are all among the factors in America’s high death rate for mothers.

Now that the coronavirus pandemic has made seeking medical help seem more dangerous, those factors have only been exacerbated, said the experts testifying.

They included Mark Woodland, chairman of the obstetrics department at Reading Hospital.

“Women don’t just die immediately after giving birth. They die weeks and months later, and we are missing that,” said Woodland,

who added, “there is such a thread of racism through all this.”

“Bias in health care is one of the deadliest threats to maternal and child health care,” said Kimberly Seals-Allers, maternal and infant health strategist and founder of Irth app. “Until we address bias, we’re not looking at this problem holistically, or looking at the problem at its core.”

“And the scope of the problem is not just measured in death,” Seals-Allers said. “Too many black and brown mothers have a story.”

She said “Black and Latina infants get worse care. Doctors give different treatment to women with the same symptoms depending on the color of their skin.”

“Implicit bias often shows up in healthcare settings when healthcare providers do not acknowledge pain, when providers restrict traditional cultural birthing practices, or ultimately take on a hierarchical decision-making role because of the stereotypes they hold or deeplyrooted biases,” said Zahada Gillette-Pierce, a trainer at the sexual and reproductive health organization AccessMatters.

African-Americans are four times more likely to die in connection with pregnancy, according to Aasta Mehta, medical officer of women’s health at the Philadelphia Department of Public Health’s, Division of Maternal, Child and Family Health.

She is involved in providing training to re-educate providers “to create a safe space and help eliminate bias.”

The pandemic “has exacerbated these issues and exposed the structural racism and health disparities,” testified Robert Ferguson, chief policy officer for the Jewish Healthcare Foundation.

“This is a fundamental issue of reproductive justice. We have to be honest about the racism and gender-based violence during this crisis,” said La’Tasha D. Mayes, president and CEO of New Voices for Reproductive Justice.

“If our country is having a reckoning, we must dismantle the institutional against women who just want to have children,” said Mayes. “Race or zip code should not determine if someone has a healthy birth or not.”

Those testifying said

these disparities have existed for decades and, like so many inequities, have been made worse by the coronavirus pandemic.

Among the most obvious impacts are the economic damage to health providers.

Birth Options Closing

On Aug. 12 at 2:28 p.m., Adalyn Grace Grippo became the last baby born at Pottstown Hospital.

Delivered by Charles Touhey, Adalyn Grace weighed in at 7 pounds, 5 ounces, and measured 20-inches in length. Mom and baby were discharged at 8:30 p.m. on Aug. 13, just hours before Tower Health closed the maternity ward for good in a cost-cutting measure.

It will be the first time in more than 100 years Pottstown has not had a health facility dedicated to birth.

That’s not the only maternity facility that’s been closed by Tower Health.

The Reading Birth Center was also closed, Nicole Chaney, a midwife who worked at the center, told the legislators during testimony.

“Profits were prioritized over the lives of our mothers,” said Chaney.

Chaney said midwifery is not only a preferred birth experience for families, but is less expensive to maintain. “It’s easier to support mid-wifery than open a maternity ward,” she said.

Emily McGahey, associate clinical director of The Midwife Center for Birth and Women’s Health, said a recent study found “birth centers have better outcomes.” She said they cost about 21 percent less than maternity wards and 16 percent fewer of their babies die in the first year of life.

The pandemic offers “an opportunity to re-think how we fund resources around maternal health,” said Cephas.

The economy is not just affecting health care providers, but their patients as well.

“That those who are unemployed no longer have health insurance is a harrowing fact,” said Schwank. Even before COVID-19, “one quarter of women were unable to access the recommended number of prenatal visits.”

“I know we have a lot of work to do,” said Schwank.

A video of the testimony is available on Boscola’s website.