Maternal death rate in Mississippi increases
A 2023 report released in early December by the Mississippi State Department of Health shows that maternal deaths in the state of Mississippi have been steadily rising in recent years.
The report, conducted by the Mississippi Maternal Mortality Review Committee (MMRC), examined the state’s maternal mortality data from 20162020.
Mississippi’s pregnancy-related mortality rate saw a significant uptick from 2016 at 26.4 deaths per 100,000 live births to 42.2 deaths per 100,000 live births in 2020.
During this same time span, 80% of pregnancy-related deaths were deemed preventable, and roughly 92% had some level of opportunity to alter the final outcome (death).
Dr. Rachael Morris, a maternal-fetal medicine specialist and associate professor in the Department of Obstetrics and Gynecology at the University of Mississippi Medical Center, said the findings within the report were alarming.
“When I looked at the statistics in the morbidity and mortality committee reports, there’s the frightening percentage of four-fifths of deaths that we’re deemed to be a preventable death,” Morris said. “To me, that’s just really sad.”
“Unfortunately, our Black mothers, based on these statistics, mortality rates were four times that of white women. It’s actually incredibly scary,” Morris said. “This further adds concern and the need to attack these problems.”
Morris said there is not a single answer to solve this complex health issue, but they are “fundamental changes” that need to be addressed and implemented to reduce high maternal rates in the state.
Insurance insecurities, social determinants of health care and increased education were some areas of care she believes the health care system should focus on.
“There are so many pieces to this puzzle, so it can’t just be fixed in one area like OB or just looking at access to care. It has to be simultaneous interventions that are consistently employed,” Morris said.
“For instance, you might be able to increase access to quality care, but if someone doesn’t have insurance, then they’re still not going to be able to pay for the necessary care. If we’re not addressing social determinants of health, to make sure that someone has a ride to get to the facility, then it doesn’t matter how many facilities she has, if she can’t get there.”
Just this year, the Mississippi Department of Health deployed an initiative that grants Mississippians in counties with Uber services the ability to request free rides to their county health department appointments until the end of June 2024.
Morris said once a patient arrives, providers must be ready to educate the patient. She said health literacy allows a patient to understand their medical problems and the severity of their medical problems.
According to the report, cardiovascular disease and hypertension are the top contributors to maternal mortality in the state.
Morris said hypertension is a known risk factor for preeclampsia — high blood pressure that occurs during pregnancy. Preeclampsia is also one of the leading causes of major complications in pregnancy in the second and third trimester.
She said taking the step to prevent further worsening of a condition and poor outcomes can impact a patient over a lifetime.
“When a mother is faced with the unknown, whether it’s a maternal or a fetal complication, it’s really important to have a very collaborative approach with some specialists and a plan. This way the mother has time to process her experience and also have an opportunity to impact change in her outcome,” Morris said.
“Education of the patient is probably one of the most important things that we as providers can do to help a patient really understand the level of her condition.”
As a team member of the Mississippi Center for Emergency Services at UMMC, Morris works in a program called STORK. That is short for Stabilizing OB and Neonatal Patients, Training for Ob/neonatal Emergencies, Outcome
Improvements, Resource Sharing, and Kind Care for Vulnerable Families.
STORK is an educational and simulation-based program where providers are training non-obstetricians such as ER staff, EMS paramedics again, firefighters and others how to stabilize pregnant moms in crisis until transported to a higher level of care.
“Over 50% of our counties are considered obstetric care deserts. So, we have a lot of patients that are recognizing they may have a problem and unfortunately, it’s two hours to get to the to the nearest OB unit,” Morris said.
“It’s the medical community as a whole that has to be educated. When you have counties that don’t have obstetric providers and the closest emergency room is a critical access hospital, those people have to be ready to take care of some of these issues too,” Morris said. “This problem did not occur overnight. And it is certainly not slowing at this point.”
Dr. Daniel Edney, the state health officer, commented in a news release about the maternal mortality study, stating: “Losing one mother is too many.”
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