63% of Mich. maternal deaths preventable

Effort to improve access to care and services continues

Kristen Jordan Shamus

State health leaders are looking for ways to cut the rate of maternal mortality in Michigan, which more than doubled from 2018 to 2019 to a rate of 23.2 pregnancy-related maternal deaths per 100,000 live births.

Official data on maternal mortality in Michigan for 2020, the first year of the coronavirus pandemic, won’t be released until early 2024, state health officials told the Free Press. But among the pregnancy-related maternal deaths that occurred between 2015 and 2019, more than 63% were preventable, state data shows.

Elizabeth Hertel, director of the Michigan Department of Health and Human Services, is planning a series of town hall meetings across

Hertel the state in April and May to learn about how well newly launched programs, like the Healthy Moms, Healthy Babies initiative, are working to help those at highest risk of health complications tied to pregnancy and childbirth.

“We’re seeing so much investment and so much support for pregnant women and their families,” Hertel told the Free Press earlier this week. “The children are getting a healthy start. Parents are getting a healthy start to continue to create strong, stable families. And I think those investments are just so important as we move forward and create a Michigan where we know people want to move and where people want to stay.”

The following are questions and answers from Hertel’s interview with the Free Press:

What stands out when examining the rates of maternal mortality in Michigan?

“We have very high maternal mortality rates in Michigan. Our rate went down from 2015 to

2018, from 14.1 per 100,000 live births to 10.9, which is fantastic, but what we do know is that we continue to have a number of maternal mortality deaths that are preventable,” she said. Data from 2019 showed the rate more than doubled to 23.2 per 100,000 live births.

“Approximately 60% of those are preventable every year. So we continue to work on addressing those disparities and working with the communities and pregnant women in those communities to ensure that they have access to the care and services that they need to avoid any complications with their pregnancies.”

How does Michigan compare when it comes to maternal mortality?

“Every state compiles the data in different ways. When we looked at CDC (Centers for Disease Control and Prevention) data, they identified the same disparities in the maternal death rate,” Hertel said. “They’re very high for Black or African American women — significantly higher than they are for white women. And we know that other states are experiencing the same disparities.”

In Michigan, Black women were 2.8 times more likely to die from pregnancy-related causes in 2015-19 than white women. The maternal mortality rate for Black women was 29.8 per 100,000 live births. For white women, it was 10.7 deaths per 100,000 live births.

“So what we’re focusing on here is minimizing or eliminating those disparities, and that is the … primary objective of the Healthy Moms, Healthy Babies initiative in Michigan.”

What are the key pieces of that program to help new mothers and their babies?

Healthy Moms, Healthy Babies funds several programs that connect Michigan families to support and resources, including home visits that begin during pregnancy. They can help families with everything from coordinating health care to education about breastfeeding, infant care, child development help and more.

“When this began in 2021 … what we were

Elizabeth Hertel, able to do was expand postpartum Medicaid coverage to 12 months after birth, which is significant for moms,” Hertel said. Depending on the program, home visits can continue until a child turns 5.

“We invested in evidence-based home visiting, which includes tribal home visiting, and is very important to support families who may be impacted by the child welfare system or substance use disorders. We expanded Medicaid coverage to cover doula services and invested in pilots for peer navigators to help connect families who might be impacted by substance use disorders in the state.”

How many people are currently enrolled in that program?

“Because there are a number of programs within the Healthy Moms, Healthy Babies initiative, if you break it down into our Medicaideligible families who’ve been using … the app for … home visiting … we have had over 100,000 encounters since Dec. 1 of last year, which is very significant,” Hertel said.

“We’ve got about 4,300 individuals who are covered by Medicaid who’ve engaged with us for resources within this app since we launched it in August,” Hertel said. “We also know that we’ve had approximately 400 home visiting referrals each week.”

How much is needed to fully fund the Healthy Moms, Healthy Babies program?

“The governor proposed an increased investment of $68.3 million for continued and expanded maternal-infant services and programs,” Hertel said.

Of that, $32.1 million would remove the fiveyear waiting period for children and pregnant women who are legally residing in Michigan to access Medicaid; $6.2 million would support reimplementation of the Plan First family planning benefit; $10 million would expand the CenteringPregnancy sites that are providing supportive prenatal care; $10 million would be spent on continuation of the Michigan Perinatal Quality Collaborative, and $10 million also would support birthing hospitals across the state.

“I never try to guess on the likelihood of anything passing,” Hertel said, “but I know that given the positive outcomes that we’ve seen with the continued investment into programs to support pregnant moms, families and children that these are investments that I think most people support.

“We want to see healthy moms and healthy babies in the state. We want to reduce disparities and reduce maternal mortality and morbidity rates. So, you know, I’m always hopeful that we’ll see continued investments.”

Where does Michigan stand with infant mortality rates?

Michigan broke a record in 2021, marking the lowest-yet known infant mortality rate, state health data shows.

“The infant mortality rate was the lowest in 2021 at 6.2 deaths per 1,000 live births, which was really exciting,” Hertel said. “It’s the first time we have really seen significant improvement. And those are the results of investing in the regional Perinatal Quality Collaborative, increasing access to support like evidence-based home visiting, addressing the social determinants of health issues and those systemic inequities and just continuing to support and educate women and families on how to access care and the importance of accessing care while they’re pregnant.”

How can people access these programs and get help?

“I always direct people to MIBridges, which is our program to help people determine whether or not they’re eligible for services in the state of Michigan,” Hertel said.

She also recommended contacting your local health department or calling 211 to find out what assistance is available during pregnancy and after childbirth.