Updates

Maternal mortality in Texas

Wellness

According to a recent study in the medical journal Obstetrics & Gynecology, the rate of maternal mortality in Texas has increased significantly, from 18.6 deaths per 100,000 live births in 2010 to over 30 per 100,000 in 2014.

In the U.S., maternal deaths have jumped 27 percent from 2000 to 2014. This rate is significantly higher than a number of other countries, including Italy (2.1 deaths per 100,000 live births), Japan (3.3) and France (5.5), and more in line with Turkey and Chile (15.2) or Mexico (38.9), according to World Health Organization statistics. The U.S. is one of only four countries where the maternal mortality rate has increased in both 1990-2000 and 2000-2010. The problem is incredibly complex, and the reasons for losing a mother are numerous. In Texas, maternal deaths within one year of the end of a pregnancy were studied and the leading cause of death was a cardiac event (20 percent). Other explanations include drug overdose, problems related to high blood pressure (including toxemia or preeclampsia), bleeding and suicide. The study also showed that women who are black, obese, have high blood pressure, diabetes, deliver via cesarean section or who seek prenatal care late are all at an increased risk for maternal mortality. To better understand the problem of maternal death, in 2013 the state legislature directed the formation of a task force to review the details of each case and make recommendations for how they could be prevented in the future. The detailed reviews will give us the additional information we need to invest in the right solutions for the problems we face in Texas. Houston is an area particularly affected. Here, like the rest of the state, African-American women bear the greatest burden and they are three times more likely to die during or after a pregnancy than are women of other races. This is an incredibly important issue that needs urgent attention. Texas Children’s Pavilion for Women is making a difference by providing access to:

  • screening and treatment for depression
  • state-of-the-art prenatal care for women with congenital heart disease
  • preconception counseling
  • preventive health care between pregnancies

What can you do?

  • Know your risk. Do you have any of the risk factors (diabetes, high blood pressure, obesity) for maternal complications?
  • Reduce your risk. If you have high blood pressure or diabetes, talk with your doctor BEFORE you get pregnant so you can get your medical conditions under control and start pregnancy as healthy as possible. If you are obese, talk with your doctor about things you can do to get to a healthier weight before getting pregnant and understand how much weight is appropriate to gain during pregnancy.
  • Seek care early. Seeing your midwife or doctor for the first visit during the first 12 weeks of your pregnancy gives you the best chance for health screening that might uncover problems you didn’t know about.
  • Prioritize yourself too. Don’t skip the postpartum visit. We know you are busy with baby, but your health is important too. This visit lets you and your midwife or doctor ensure your body is back to normal and, equally important, talk about ways you can stay healthy between pregnancies.
  • Be patient. Spacing of at least 18 months between your pregnancies will reduce your risks in your next pregnancy and reduce the chance that your baby will be born too soon.
 This blog was co-authored by Dr. Lisa Hollier & Dr. Carla Ortique.