The Texas Maternal Mortality and Morbidity Task Force is absolutely correct in its statement that the loss of one mother is one too many. The Task Force’s recently released report shows that of the maternal deaths reviewed for 2012, most of them were preventable.
Leading causes for maternal mortality in Texas are cardiac disease; behavioral-health disorders, including opioid overdose and suicide; and hypertension. Lack of access to care is a key cause of maternal mortality and severe maternal morbidity (the near misses). Most of the maternal deaths occurred 42 days or more after delivering. Pregnancy-related Medicaid and CHIP perinatal end two months or less following birth.
What we know from the report:
- Access to care is a driving force to maternal mortality and morbidity.
- Health disparities (particularly for black women) are significant, with higher numbers of maternal deaths and morbidity associated with pregnancy, regardless of coverage status or socio-economics.
- Cardiac disease, hypertensive disorders, and hemorrhage are leading causes of maternal deaths.
- Substance abuse and behavioral health issues are contributing to overdoses, the leading cause of maternal deaths in the first year after delivering.
What the task force has also unveiled are missed opportunities for the screening of chronic conditions—both physical and behavioral—and the need to enhance access and continuity of care, before and in between pregnancies. The American College of Obstetricians and Gynecologists (ACOG) has consistently supported programs to enhance interconception care, including our work with the Texas Health and Human Services Commission and itsHealthy Texas Women and Family Planning programs.
ACOG has clear statements of best practice and protocols to recognize and treat high risk conditions, including screening for perinatal and postpartum depression that could lead to maternal death. What we as ob/gyns need is the support and resources available to treat and/or refer our most at-risk women.
ACOG is committed to providing the highest level of care for the women of Texas. We will continue to advocate for our patients and for the resources needed to provide the best care for our patients. This report is another step for Texans to better understand our plight and provides an opportunity for patients, providers, and lawmakers to work together to provide better outcomes for Texas mothers.