Northwest Arkansas Democrat-Gazette
A Mother’s Day wish
No better time to emphasize maternal health goals
“Ahealthy mother and a healthy baby — that is the goal.” My attending physician spoke a version of that statement as the team I was part of during my medical residency began each obstetrics rotation. Years later, these simple yet eloquent words continue to guide many in our profession as we strive to provide the best medical care possible. More importantly, they serve as a basic and extremely reasonable expectation for mothers and families.
The United States witnessed significant advancements in health care during the last century that resulted in a dramatic decline in maternal mortality rates. However, recent years have suggested a reversal of fortune, with the U.S. having one of the highest maternal mortality rates in the industrialized world. Arkansas stands out with the highest rate in the nation at 43.5 deaths per 100,000 births, according to Centers for Disease Control data from 2018-2021.
Maternal mortality review committees define pregnancy-associated death as any death during pregnancy or within a year of its end, regardless of cause. Pregnancy-related death specifically refers to deaths caused by pregnancy complications, or a chain of events initiated by the pregnancy. However, what should not be lost in this conversation is a discussion on morbidity — unintended outcomes of labor and delivery that result in significant short-term or long-term consequences to a woman’s health.
I’m honored to serve as chair of the Arkansas Maternal Mortality Review Committee. Formed in 2019, our committee is tasked with reviewing every pregnancy-related death in the state and identifying contributing factors and potential solutions. The committee has identified cardiac conditions, hypertensive disorders, infections and hemorrhage among the leading causes of death. We’ve also discovered that women over the age of 35 and Black women experience markedly higher rates of pregnancy-related deaths. And most alarmingly, according to our reviews, more than 90% of all pregnancy-related deaths are preventable.
In Arkansas, a comprehensive approach is being taken to improve maternal health, spearheaded by a variety of initiatives that target education, accessibility and quality of care. The Governor’s Arkansas Strategic Committee for Maternal Health is at the forefront, advocating for better education about women’s and maternal health, especially during the prenatal and postpartum periods. The committee is also focused on improving maternal health services before, during and after pregnancy and increasing access to these services statewide. Furthermore, it emphasizes the importance of coordinated statewide efforts for better data collection and reporting.
Parallel to these efforts, the Arkansas Perinatal Quality Collaborative, founded in 2022, has become a critical player in the state’s health care landscape. This network, which includes health care facilities, teams, policymakers, patients and experts, aims to significantly improve the quality of maternal health care. By supporting hospitals with data-driven and evidence-based initiatives, the collaborative hopes to enhance both maternal and neonatal outcomes using quality improvement methods and implementation science.
On a national level, the CDC’s “Hear Her” campaign is designed to enhance awareness of critical warning signs during and after pregnancy. It empowers pregnant and postpartum women to confidently voice their concerns and symptoms to health care providers. It also encourages important conversations between pregnant and postpartum individuals and their support systems, facilitating dialogue that can identify problems and potentially save lives. Additionally, it provides essential tools and resources for both patients and health care professionals to engage in effective communication, leading to timely and life-saving interventions.
Despite these measures, Arkansas continues to face substantial challenges in maternal health care. Obstacles include a decline in maternity units, a shortage of health care professionals specializing in maternal care and persistent socioeconomic barriers that worsen health disparities. The state’s rural nature further complicates access to care, leading to the creation of “maternity deserts” where services are scarce.
In addressing these issues, the role of the family, particularly fathers and partners, is pivotal. Partners’ active engagement during pregnancy, childbirth and the postnatal period can dramatically improve health outcomes for both mothers and infants. This involvement helps alleviate psychological stress on mothers, provides emotional support, facilitates shared decision-making and assists in household responsibilities. Such support reduces risks like postpartum depression and ensures mothers receive timely medical care.
When partners attend prenatal visits, mothers are more likely to access necessary medical services. Plus, partners’ attendance helps them understand the health needs of mothers during and after pregnancy. This comprehensive involvement helps create a supportive home environment, challenges traditional gender roles and promotes gender equality in caregiving.
With Mother’s Day fresh on our minds, it’s the perfect time to uplift the conversation around improving maternal health care in Arkansas. There’s a crucial need for a united effort from all stakeholders — health care providers, patients, policymakers, facilities, systems and communities — to continue developing and implementing effective strategies for improving care and access across the state.
Making Arkansas a safer, healthier place to be a mom is the greatest gift we can give all our mothers and families every day of the year.