Maternal death rates are on the rise in some regions, pushing leaders in several states to investigate the trend and putting hospitals on alert.
Maternal deaths have been trending up since the late 1980s, according to data from the Centers for Disease Control and Prevention. In 1987, there were 7.2 deaths per 100,000 births, rising to a peak of 17.8 deaths per 100,000 births in 2009 and 2011. In 2013, the most recent year recorded by the CDC, the rate was 17.3 deaths per 100,000 births.
In Texas in particular, the numbers are startling. Women in the state are ten times more likely to die from pregnancy-related complications than women in Spain or Sweden, reports The new York Times. Across the country, American women are five times more likely to die in pregnancy or childbirth than British women.
Texas legislators passed several bills aimed at curbing the trend on Monday, reports The Texas Tribune. The bills would direct the state’s Task Force on Maternal Morbidity and Mortality to continue to study the issue and adding a labor and delivery nurse to the team.
Ultimately, increased emphasis on prevention programs would save lives and lower costs, the author of one of the bills, Republican representative Cindy Burkett, said.
“As in many things, prevention is better and often cheaper," Burkett said.
In Texas, some of the issue can be linked to restricted access to reproductive health services. State investigations found the rate is especially high among black women in Texas, who made up 11.4% of births in Texas but account for 28.8% of pregnancy-related deaths, according to the El Paso Times. By comparison, white women made up 34.8% of pregnancies in the state, and accounted for 37.8% of pregnancy-related deaths.
In Massachusetts, the deaths of two women in childbirth at MetroWest Medical Center, a Tenet Healthcare facility, have prompted a state probe, according to an article from The Boston Globe. The hospital responded to the first death in October with a “corrective action plan” that updated guidelines for treating women who have preeclampsia, though federal investigators cited the hospital in February for not fully implementing the plan.
The inquiry into the second death, which occurred three weeks after that inspection, is still ongoing, state investigators told the newspaper.
Massachusetts’ maternal death rate has been typically well under the national average, about 6.9 deaths per 100,000 live births in 2014, the most recent year on state record, according to the Globe.
But patient mortality is just one piece of the maternal health safety puzzle, said Hafsatou Diop, M.D., a state epidemiologist who directs efforts on maternal health. Diop told the newspaper that many women survive childbirth but suffer other complication like excessive blood loss or transfusion that are related to the pregnancy. Diop said the state plans to release a report in the near future on other pregnancy complications.
“Mortality is just the tip of the iceberg,” she said.