States are not doing enough to understand what went wrong after mothers die from pregnancy-related complications—a necessary step to figuring out how to stem growing maternal mortality rates in the U.S., experts told lawmakers on Thursday.
The shortfalls were being examined during a House subcommittee hearing held to consider a measure to provide more funding to state maternal mortality task forces. The goal, officials said, is for states to capture standardized data needed to explain why maternal mortality rates in the U.S. are higher than in other developed nations.
“This is an issue we cannot solve without accurate data,” said Energy and Commerce Health Subcommittee Chairman Rep. Michael Burgess, M.D., R-Texas, who is an OB-GYN. He cited Centers for Disease Control and Prevention data showing that the U.S. maternal mortality rate reached 18 deaths per 100,000 births in 2014, up from 7.2 deaths per 100,000 births in 1999.
But there is little standardized data state-to-state data to explain the story behind those deaths, he said.
“Physicians, public health officials and Congress are unable to reach conclusions based on current data about what the causes of maternal mortality increases are," he said. "Once we establish what they are there will be an opportunity to implement the data."
The hearing came on the heels of a USA Today piece published earlier this month called "What states aren't doing to save new mothers' lives." USA Today previously published an investigation about maternal mortality rates and how U.S. hospitals often aren't following best practices to protect patients.
While there are task forces across the country already, the news organization reported, many states have avoided "scrutinizing medical care provided to mothers who died, or they haven't been studying deaths at all," the news organization reported.
"It is a common phenomenon across the country," testified Joia Crear-Perry, M.D. "It's not just Texas and it's not just Pennsylvania. A lot of states need this money to help with collect more accurate data."
Burgess pointed to successful efforts in Texas to understand deaths of women during or following childbirth after media reports on startling rates of maternal deaths. In response, the Texas legislature passed bills to direct the state’s Task Force on Maternal Mortality and Morbidity to study the issue. That state now knows the leading causes for maternal deaths are related to cardiovascular problems, hemorrhage, sepsis and cardiomyopathy, he said.
"We see in places that are closing rural hospitals in Texas and in Georgia, when women have to travel more than an hour to have a baby, they are more likely to hemorrhage, they are more likely to have a heart attack, they are more likely to have these medical conditions," Crear Perry said. "If you don't have a systemic review, you can't look at the match between where your access is being denied and where women are also dying in the same place. Having a more robust view of the deaths is one way to address that."
The data is also needed to explain why problems persist at reputable hospitals, testified Charles Johnson, who founded the organizatoin 4Kira4Moms after he lost his wife Kira Dixon Johnson following the birth of their second child at Cedars-Sinai Medical Center in 2016.
He said his wife, who was healthy and underwent a routine scheduled C-section, died following multiple delays in care in the hospital after she began exhibiting symptoms of internal bleeding as she recovered.