Texas struggles with rising maternal death rate

[GMDino]

http://www.usatoday.com/story/news/health/2016/09/10/texas-maternal-mortality-rate/90115960/

Quote:HOUSTON – Pregnant women visiting the Center for Children and Women get more than ultrasounds and vitamins. They get their blood pressure checked, mental health screenings, diabetes tests and lab work – all under one roof.


The clinic is on the frontlines of trying to reverse a disturbing trend in Texas: Women in the state are dying of pregnancy-related ailments at a higher rate than the rest of the country and even most other industrialized countries. And no one’s sure exactly why.

“This is an incredibly important issue that needs urgent attention,” said Lisa Hollier, the center’s medical director and head of the state’s Maternal Mortality and MorbidityTask Force.
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The rate of maternal mortality in Texas spiked from 18.6 deaths per 100,000 live births in 2010 to more than 30 per 100,000 in 2011 and remained over 30 per 100,000 through 2014, according to a recent study in the medical journal Obstetrics and Gynecology. That’s significantly higher than Italy (2.1 deaths per 100,000 live births), Japan (3.3) and France (5.5), according to World Health Organizationstatistics.

Across the USA, the rate of maternal deaths also jumped from 18.8 per 100,000 live births in 2000 to 23.8 in 2014 – a 27% jump, the study showed.

Maternal deaths are still relatively rare. Texas, for instance, tracks about 150 deaths a year out of around 400,000 live births. But the rate of increase and the fact that the numbers are rising in the USA while dropping in other industrialized countries is cause for alarm, said Eugene Declercq, a professor and assistant dean at Boston University School of Public Health and co-author of the study.

“We are so far behind these other countries, there’s clearly a problem here,” he said. “There’s real reason to be concerned.”

Causes of maternal deaths in Texas range from cardiac events to hypertension, drug overdose and suicide, according to a report released earlier this year by the Texas task force. The report, which looked at deaths in 2011 and 2012 associated with pregnancy up to a year after giving birth, also found that African-American women were disproportionately more likely to die in pregnancy-related deaths than white or Hispanic women.


Angela Lynch, OB nurse navigator, speaks with Micaela OrtegaThursday at the Harris Health System's OB/GYN Clinic in Houston, TX. (Photo: Eric Kayne, for USA TODAY)

Though only 11% of all births in Texas were by black women, they accounted for 29% of maternal deaths, according to the Texas report. Hispanic women accounted for nearly half – 48% – of all births, but made up 31% of maternal deaths.

Why exactly Texas women are falling through the cracks and dying from seemingly preventable ailments – and why African-American women are more likely to be impacted – remains a mystery, said June Hanke, a task force member and analyst with the Harris Health System in Houston.

The task force is taking a deeper look at the Texas deaths for more clues. “We’re just getting started,” she said.

Some point to the state’s cut of family planning services and refusal to expand Medicaid under the Affordable Care Act as possible reasons. In 2011, Texas lawmakers slashed the family planning budget by more than $70 million and, two years later, greatly reduced the number of abortion clinics in the state by mandating they meet ambulatory surgical center standards and employ doctors with admitting privileges at hospitals. The Supreme Court this summer ruled against the abortion restrictions.

But the family planning services cuts didn’t kick in until September 2011 and don’t account for the sharp spike in maternal deaths logged at the beginning of that year, Hollier said. The cuts in health care may have contributed but are not the sole culprit, she said.

George Saade, head of obstetrics at the University of Texas Medical Branch in Galveston, was so alarmed by the rise in maternal deaths in Texas in recent years that he co-wrote a paper in Obstetrics and Gynecology four years ago, warning of the trend and calling for changes.

Growing obesity in Texas women and increased cases of hypertension and other ailments while pregnant make them a health risk unlike any seen in recent years, he said. A thorough regiment of mental and physical screenings before, during and after pregnancies is needed to make sure women stay healthy for births – and beyond, he said.

“We have to accept that pregnant women these days are more complex and at risk than before,” Saade said. “We can’t follow the care we did 50 years ago and hope it’s going to get better.”

Part of the problem is that pregnancy health care traditionally focused on the health and survival of the baby and not the long-term health of the mother, said Elliott Main, medical director of the California Maternal Quality Care Collaborative and professor at Stanford University School of Medicine.

[Belsnickel]

I was wondering when this story was going to be brought up. Been seeing this news for a few months, now.

[GMDino]

(09-10-2016, 02:30 PM)Belsnickel Wrote: I was wondering when this story was going to be brought up. Been seeing this news for a few months, now.

Maybe taking care of poor women whoa re pregnant will make America Great again?



I can see people really care about the world's greatest health care system. 

[JustWinBaby]

I assume most had Obamacare???

[Benton]

(09-11-2016, 03:04 AM)JustWinBaby Wrote: I assume most had Obamacare???

so you're saying more insurance is to blame for more women dying?

[Belsnickel]

So, as a side story to this, there is going to be a rule attached by the Obama administration regarding Title X, or federal family planning, dollars. This rules will says that a state cannot prevent a facility from receiving these funds in their state unless the facility is proven to be unable to provide the services the money is intended for. This prevents states from defunding Planned Parenthood clinics.