The number of women who die during pregnancy or in the first year after giving birth has increased across the country in the last few decades. That’s after centuries of decline.
Some Kentucky lawmakers are trying to reverse the trend, which officials attribute to an increase in substance use disorder and a lack of access to health care.
According to Kentucky’s latest maternal mortality report, in 2017, 50% of maternal deaths were pregnancy-related, 46% involved a substance-use disorder and 78% of cases were preventable.
And the rate of maternal mortality is even higher for Black Kentuckians—in 2018, 42.1 Black women died for every 100,000 live births compared to 17.2 white women for the same group size.
The legislature’s Interim Committee on Health and Welfare discussed maternal mortality on Wednesday.
Jeffrey Goldberg, a doctor and state legislative chair for the American College of Obstetricians and Gynecologists, told the committee that maternal deaths aren’t nearly as common as they used to be, but the increase is concerning.
“The U.S. has the worst maternal mortality rate in the entire western world. And we feel given our resources, that’s unacceptable,” Goldberg said.
ProPublica documented the high rate of pregnancy and childbirth related deaths in the U.S. in its series, Lost Mothers.
Lawmakers have proposed several measures to try and combat the trend in recent years. Earlier this year, a group of Democratic women in the legislature filed 21 bills to try and expand health care access to mothers and children, though none of the measures passed.
Leitchfield Republican Rep. Samantha Heavrin’s bill requiring the state’s annual report on child and maternal fatalities to include information on race, income and geography passed into law.
But on Wednesday, the state’s deputy public health commissioner Connie White said some of the new requirements couldn’t be implemented.
“The numbers are very small in a lot of these reports and to put a point on a map in a county really does take away a patient’s anonymity,” White said.
Dr. John Weeks, a maternal fetal medicine specialist with Norton Healthcare, said he’s seen a 25% increase in maternal mortality attributable to addiction.
“Most have a psychiatric comorbidity that was important, anxiety, depression, other more serious conditions, PTSD. We don’t have enough mental health professionals to reach out to all the areas of the state that desperately need this kind of help,” Weeks said.
White, Kentucky’s deputy public health commissioner, said health care providers need to be part of the solution.
“This is a culture change: if we can go into a labor delivery unit, give them the data, show them how they approach these pregnant women and these delivering moms and what they do and follow up with that delivery, they will do that,” White said.
Goldberg, with the American College of Obstetricians and Gynecologists, said maternal deaths are just the “tip of the iceberg” for other maternal health problems.
“We know that for every case of a woman who has died from infection or bleeding or another cause, that’s an indicator for many, many other patients who’ve had the same problem,” Goldberg said.