For the safety of mothers and families in Idaho, we must act to develop a statewide maternal mortality review committee. Maternal mortality is on the rise and Idaho is no exception to this alarming trend. Pregnancy related deaths have doubled in the U.S. in the past 20 years. The United States is now the most dangerous country in the developed world to give birth. This stands in stark contrast the rest of the developed world where there has been a steady decline in maternal mortality. To give perspective, 26 moms die per 100,000 live births in the U.S. Canada has 7 maternal deaths per 100,000 births while Spain has 5 maternal deaths per 100,000 births. Idaho has 27 moms die per 100,000 live births.
It is important to determine why moms die from pregnancy-related causes. Lack of information prevents us from analyzing and addressing contributing factors and trends in maternal deaths. Many states which implemented maternal mortality reviews have used their findings to target education that improves maternal outcomes. The literature suggests 20-50 percent of maternal deaths are preventable. A recent analysis of six states with a maternal mortality review committee found that 59 percent of maternal deaths are preventable. We can save lives if we look carefully at each incident.
Some people have questioned the value of a maternal mortality review committee because we have numerically few maternal deaths per year in Idaho. The maternal mortality review committee would analyze maternal mortality but keep in mind that for every 1 maternal death, there are 100 instances of severe maternal injuries related to pregnancy. Maternal deaths and injuries parallel each other. If we reduce maternal deaths, we will see reduction in the number of cases of severe maternal injury. Maternal deaths are the tip of the iceberg. We have a huge opportunity to improve the health of many women.
The review committee would be administered by the Department of Health and Welfare. A panel would review the circumstances of each maternal death with the goal of identifying modifiable risk factors. The data would be de-identified prior to review by the panel. The maternal mortality review committee will be confidential, educational and is not for punitive purposes. A maternal mortality review committee is a powerful tool to improve maternal health outcomes.
The benefits of a maternal mortality review committee are proven in many other states. In Michigan, for example, increased access to substance use disorder treatment for pregnant women decreased the state’s maternal mortality rate. In Florida, an urgent message to providers on placental disorders saved lives. In Ohio, emergency simulation training for small rural hospitals improved outcomes for pregnant women in the state. These are just a few examples of success stories due to maternal mortality review committees and they highlight the need for state specific data. Idaho’s challenges may or may not be the same as other states in the U.S.
Legislation is necessary in order to set up a functional maternal mortality review committee. Some key components include: the authority to access data such as medical records and autopsy reports, confidentiality and protection of collected data and proceedings, regular reporting and dissemination of findings, creation of a multidisciplinary committee that will represent a variety of clinical and psychosocial specializations and members working in diverse communities and from different geographic regions of the state.
Idaho is one of the few remaining states without a maternal mortality review committee The death of a mother devastates her family, her community and the medical team involved in her care.
As a mother and an obstetrician/gynecologist, I stand with doctors, midwives, nurses and safety experts in Idaho to advocate for a statewide maternal mortality review committee We can do better. We can save mothers’ lives. House Bill 109 which establishes a statewide maternal mortality review committee passed through the House last week. It will go to the Senate for a vote very soon. Please contact your senator and encourage him/her to vote yes on House Bill 109. Let’s eliminate preventable maternal deaths.
Dr. Amelia Huntsberger is a obstetrician/gynecologist who has been practicing at Sandpoint Women’s Health for six years. She trained and worked as a doula prior to medical school. She went to medical school at the University of Washington and completed residency at the University of Michigan. She serves as treasurer for the Idaho section of the American College of Obstetricians/Gynecologists and as Board Member of the Idaho Perinatal Project. She is married to Dr. Vince Huntsberger and they have three children.