National Consumers League

What California is doing to lower maternal mortality

Nissa ShaffiThe United States currently has the worst maternal mortality rate in the developed world, at 26.4 deaths per 100,000 live births, compared to 9.2 in the United Kingdom, 8 in France, and 5.5 in Australia. To put this in perspective, the United States currently has a higher maternal mortality rate than Saudi Arabia and Libya and is barely better than Mexico, Iran, and Russia. An even more devastating reality is the maternal mortality rate among black women, who are 243 percent more likely to die from pregnancy- or childbirth-related causes than women of any other race in America.

There is some good news amid these grim numbers. The state of California has successfully worked in collaboration with public and private healthcare stakeholders to decrease the maternal mortality rate to seven deaths per 100,000 live births.

In 2006, the California Department of Public Health (CDPH) and the California Maternal Quality Care Collaborative (CMQCC) worked together to assemble a multidisciplinary committee of clinical experts to investigate this epidemic. This committee’s focus was to determine the causes of maternal deaths and the demographics of women most affected, along with identifying opportunities to turn the numbers around.

Within the first two years of its launch, the committee was able to identify placenta accreta and preeclampsia (pregnancy-induced high blood pressure) as the two most preventable causes of maternal mortality.  Placenta accreta is a condition in which the placenta affixes to the uterine wall and fails to separate postpartum, which results in severe obstetric hemorrhaging. Upon discovering a correlation between the rise in cesarean sections (C-sections) and placenta accreta cases, the CMQCC sought to reduce the number of C-sections that were medically unnecessary.

Additionally, the CMQCC revamped California’s hemorrhage guidelines to help make childbirth safer for mothers in the state. As a result, California has created a state model that has resulted in a dramatic decrease in maternal mortality, while the rest of the country continues to experience an increase in rates.

California has set an example for the rest of the country. Other states would do well to take a page from its example and turn around this alarming trend of increased maternal fatalities. In addition, a bill currently being voted on in Congress, the Maternal Health Accountability Act (S.1112), would be a federal remedy to help address this issue. The bill would require states to monitor and assess pregnancy-associated deaths and develop appropriate measures to improve the quality of maternal care. We should all ask our members of Congress to help pass the Maternal Health Accountability Act (S.1112), a bipartisan bill that could potentially save countless lives and reverse the damaging trend of maternal mortality in the United States.