Breaking down the biggest causes of death for new mothers


pregnancy

(WSIL) — The Illinois Department of Public Health (IDPH) released the second edition of the Illinois Maternal Morbidity and Mortality Report Thursday, covering deaths occurring in 2016-2017. 

Among a number of other findings, the report found that Black women continue to die at disparately higher rates due to medical causes, while White women were more likely to die from pregnancy-related mental health conditions.

Using a variety of data sources, IDPH identifies women who died while pregnant or within one year of pregnancy (pregnancy-associated deaths).

“In order to achieve health equity and reproductive justice, we as a society must recognize, discuss, and address social determinates of health,” said Maternity Mortality Review Committee Chair Dr. Robin L. Jones.  “Illinois is placing a greater emphasis on the social determinants of health to provide greater context of the woman’s community and how that may have contributed to her death.  Addressing these social determinants of health, such as insurance, health care access, socioeconomic standing, can help us determine what societal changes are needed to improve health outcomes.  We cannot achieve health equity until we address these societal factors.”

Key Findings:
An average of 75 Illinois women died while pregnant or within one year of pregnancy each year during 2008-2017, with the highest number recorded in 2017 (a total of 103 deaths).  In 2016-2017:

• 34% of women who died while pregnant or within one year of pregnancy died from a cause related to pregnancy.
• The leading cause of pregnancy-related death was mental health conditions, including substance use disorders, which comprised 40% of pregnancy-related deaths. The next three most common causes of pregnancy-related death were pre-existing chronic medical conditions that were exacerbated by pregnancy, hemorrhage, and hypertensive disorders of pregnancy.
• Black women were about three times as likely to die from a pregnancy-related condition as White women.
• Black women were more likely to die from pregnancy-related medical conditions while White women were more likely to die from pregnancy-related mental health conditions.
• One-third of pregnancy-related deaths occurred more than two months after pregnancy.
• The MMRCs determined that 83% of the pregnancy-related deaths were potentially preventable.
• 85% of the pregnancy-associated deaths by suicide and 35% of the pregnancy-associated deaths by drug overdose were determined to be pregnancy-related.
• The MMRCs determined that nearly all the pregnancy-associated homicide, suicide, and drug overdose deaths were potentially preventable.


Highlights of Key Recommendations:

• Health insurance plans, including Illinois Medicaid, should reimburse for telehealth, including phone-based services, regardless of patient or provider location.
• The state and collaborating programs should expand and facilitate coordination of home visiting programs for pregnant and postpartum women with complex medical or mental health conditions.
• The state should expand implementation of promising practices for improving maternal outcomes and empowering women to engage with health care providers.
• Hospitals should participate in the upcoming statewide birth equity quality improvement initiative with the Illinois Perinatal Quality Collaborative and should provide training and resources to staff on racism, implicit bias, stigma related to substance use disorder, and trauma-informed care.
• Hospitals should establish policies and protocols to ensure appropriate treatment of pregnant or postpartum women with substance use disorders.
• Providers should ensure that following delivery, all women are discharged from the hospital with an appointment for an early postpartum visit with an obstetric care provider within the first three weeks postpartum, followed by a comprehensive postpartum visit no later than 12 weeks postpartum.
• Providers should seek consultation when prescribing, changing, or discontinuing anti-depressants or other psychotropic medications during pregnancy, and that they ensure the patient is connected to mental health services in addition to medication therapy.
• Community-based organizations should educate women on the importance of getting prenatal care early in pregnancy.
• It is important that all women have an annual well-woman visit with a primary care provider to identify and manage any chronic conditions.  It is also important for women with a recent pregnancy to reconnect with, or establish care with, a medical home for continued medical care beyond the postpartum visit.

The full report can be found at dph.illinois.gov/mmmr.


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