Bill to look at causes of maternal deaths
Advocates say mothers unfairly blamed for being older, overweight
Landmark legislation headed to President Donald Trump’s desk would provide millions of dollars to help states determine why women are dying from pregnancy and childbirth at troubling rates. But the bill passed last week by both houses of Congress does not specifically require states to examine whether flawed medical care played a role.
Studies have found that at least half of childbirth-related deaths could have been prevented if health care providers had followed best medical practices to ensure complications were diagnosed and treated quickly and effectively.
Yet a USA TODAY Network investigation in September revealed that state maternal death review committees across the country often avoid scrutinizing medical care that occurred in the days and hours before mothers’ deaths. Many state reports instead focused on mothers’ lifestyle choices or larger societal problems, such as women being obese, smoking or failing to seek prenatal care or use seat belts.
Bipartisan sponsors and supporters of the legislation said it’s an important first step that would provide resources to ensure all mothers’ deaths are reviewed for all causes. Its language, they noted, would allow the federal Centers for Disease Control and Prevention to include scrutiny of medical care as a requirement for states to receive a grant.
“It’s impossible to read the text of HR 1318 and conclude that committees will do anything but study every single death and cause – societal, provider error or other – if they want to successfully compete for this funding,” said Angeline Riesterer, communication director for the bill’s sponsor, U.S. Rep. Jaime Herrera Beutler, R-Wash.
Supporters of the legislation said it’s crucial that delays in diagnoses and failures to treat women for childbirth emergencies are studied by state review committees – alongside societal factors – to identify trends and take action to prevent deaths.
“The key thing here is to not blame the mother,” said Cindy Pearson, executive director of the National Women’s Health Network, a consumer advocacy organization.
As the number of childbirth-related deaths has risen – making the USA the most dangerous place in the developed world to give birth – Pearson said too much blame has been placed on mothers for being older, overweight or having underlying health problems.
“That does not in any way, shape or form explain the differences in rates in our community or racial disparities,” she said.
USA TODAY’s “Deadly Deliveries” investigation focused on the role of hospital care in preventable deaths and injuries of mothers. Each year, about 50,000 women in the USA are severely harmed and about 700 die because of complications related to childbirth. Black mothers are three to four times more likely than white mothers to die or suffer devastating childbirth injuries, studies found.
At hospitals across the country, USA TODAY exposed doctors and nurses failing to follow nationally promoted best practices that make childbirth safer. Little information is publicly available to women about childbirth complication rates at maternity hospitals in their communities, and many hospitals declined to answer questions about whether they follow safety practices.
The legislation would create a national program to confidentially collect and analyze standardized data on every mother’s death. Its stated goal is to identify ways to reduce the number of deaths and serious injuries. The legislation would provide $12 million in fiscal year 2019 to bolster states with maternal mortality review committees and help create committees in more than a dozen states that lack them.
Members of Congress and health care advocates credited news coverage from USA TODAY, ProPublica, NPR and others in getting Congress to pass the legislation.
Language in the bill says that for a committee to participate in the program and receive federal funding, it must demonstrate to the CDC that its “methods and processes for data collection and review … use best practices to reliably determine and include all pregnancy-associated deaths and pregnancy-related deaths, regardless of the outcome of the pregnancy.” The legislation would require that committees submit standardized data to the CDC.