Last week the Ohio Department of Health released the latest report on maternal mortality in Ohio, A Report on Pregnancy-Related Deaths in Ohio 2017-2018. There is a lot to unpack in the report and we’ll spend more time with the details in the coming weeks. However, we identified some key data points that should be driving how we address maternal health in Ohio.
First a refresher on the multitude of terms used to describe this devastating topic.
- Pregnancy-associated death: “The death of a woman during pregnancy or within one year of the end of pregnancy, regardless of the cause.”
- Pregnancy-related death: “A death during pregnancy, or within one year of the end of pregnancy, from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy.”
A recent opinion piece in The New York Times most accurately and profoundly describes maternal mortality as “dying of pregnancy and childbirth.” The reasons why Ohioans are dying of pregnancy, at least as of 2017 and 2018, look different for non-Hispanic Black women and non-Hispanic white women.
79% of pregnancy-related deaths occurred among non-Hispanic white women and the overall leading cause of death was overdose.
Overall, 79 percent of pregnancy-related deaths occurred among non-Hispanic white women and the overall leading cause of death was overdose. The Department of Health updated its criteria for reviewing maternal deaths, resulting in more overdose deaths being classified as pregnancy-related. While more white women died overall, Black women were more likely to die from medical causes unrelated to overdoses, including embolisms, preeclampsia and eclampsia, infections and cardiovascular causes, among others. These differences are distinct and must be further explored to prevent future deaths.
Over 70 percent of pregnancy-related deaths are preventable
A shattering statistic from this report is that 72 percent of these pregnancy-related deaths were deemed to be preventable. While the criteria did change from the last report on maternal deaths, this is an increase from the 57 percent deemed to be preventable from 2008-2016.
72% of these pregnancy-related deaths were deemed to be preventable.
There is so much to understand about what is driving these deaths. We know much more than in the past about how to address pregnancy-related deaths, and clearly the interventions need to be data-driven and align with the varying needs of the women most impacted. But this is also why we need to continue to push for good data to make decisions.
Timeliness will save lives
While the report is thorough, we are working from data that is at least five years old. These women, if they had survived, would be watching their children head to kindergarten. Certainly, some issues women and people who give birth face are the same, but we need to pay attention to the nuances in the data, to know where we are making progress and where we need to do better. The issuance of this report is also two years late, according to the legislative requirement for biennial reporting (the last one was released in 2019 and admittedly was catching up on many years of not routinely reporting data).
We are working from data that is at least five years old.
In future weeks, we’ll spend more time with this data and discuss the interventions we know are most impactful to prevent deaths and further explore more nuances of this data. In the meantime, there really just one conclusion: we can do better and we must, to save lives.