Industry Voices—The maternal mortality crisis reflects the worst inefficiencies in U.S. healthcare

The U.S. has the highest maternal mortality rate among developed nations in the world, and is the only developed country where the rate is currently rising.

Nearly 700 U.S. women die of pregnancy-related complications every year and stats are particularly grim for black and Native women, who face mortality ratios 3.3 and 2.5 times as high as non-Hispanic white women, respectively. The data paints a confounding picture: In the wealthiest country in the world, which outspends all other developed nations on healthcare and is making some of medicine’s greatest advances, pregnant women face greater risk of death and permanent disability year-over-year.

While these statistics are bad enough, even more disheartening is that around three in five pregnancy-related deaths are preventable, according to a recent report from the Centers for Disease Control and Prevention.

Further, nearly 40% of deaths occur in the first 42 days after delivery, meaning there is a critical window of time between birth and the standard six-week postpartum check-up where providers are missing potentially life-saving indicators and warning signs. 

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The maternal mortality crisis is so jarring because it reflects some of the worst inefficiencies of the American healthcare system—a system where comprehensive care is fragmented, face time with providers is short, and long-term care relationships are virtually nonexistent. These inefficiencies, largely driven by financial incentives, prevent OB-GYNs from developing the collaborative relationships with their patients’ primary care providers and other specialists needed to understand maternal health in a comprehensive way. 

The good news is we know how to fix the problem.

Integrated health delivery systems (IDS) coordinate delivery of healthcare within one self-contained healthcare ecosystem. In contrast to the disorganized experience that characterizes cross-network care, these networks facilitate a culture of coordinated care in which doctors collaborate across disciplines and specialties and foster a sense of shared responsibility for patients. Providers benefit from sharing a single comprehensive electronic medical record to access a holistic view of their patients’ medical needs and history. 

These systems allow and incentivize maternal healthcare providers to pool their knowledge to identify risk factors for potentially deadly postpartum complications, such as severe bleeding, high blood pressure and infection, among others. Since postpartum care is typically limited to one check-up after the critical six-week window when many of these complications can arise, IDS have a vital role to play in creating pathways to coordinated, ongoing care for new mothers well past delivery.

IDS, and marketplaces of IDS, are also proven to promote stronger doctor-patient relationships that result in healthier outcomes for new mothers and their babies. When OB-GYNs have access to their patients’ comprehensive medical histories right from the start, they’re able to make better-informed decisions and provide more effective maternal care, with less redundant testing and paperwork.

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Providing opportunities for caregivers to develop a collaborative rapport with their pregnant and postpartum patients is essential to stemming the rising tide of maternal mortality. 

The maternal mortality statistics in the U.S. demand we take action. The road to fair and equitable healthcare for women requires the commitment of the best and the brightest across many disciplines.

It starts with listening to patients and aligning incentives so we can win back the precious time we need for building relationships with patients and collaborating with other caregivers to deliver the quality care that every woman deserves.

One path is clear: Let’s provide all pregnant women with comprehensive maternity care through integrated delivery systems and marketplaces.

Bartley Bryt, M.D. is Chief Medical Officer of Create.