House Commerce Subcommittee Issues Testimony From March of Dimes
"Thank you,
"Imagine, if you would, a classic hospital receiving blanket. It's made of soft white flannel, with a pastel blue and pink stripes on each end. Any of us with children will never forget that first moment when the doctor placed our precious baby boy or girl in our arms, wrapped warmly in one of these blankets. More than 700 times a year, a beautiful baby is wrapped up in a blanket just like this one -- but there is no mother to hold that child. That is not just a statistic; 700 mothers die every year, and over 50,000 others experience dangerous complications that could have killed them -- making the
"Our nation is in the midst of a crisis in maternal and child health. Across our nation, virtually every measure of the health of pregnant women, new mothers, and infants is going in the wrong direction. Preterm birth rates are rising. In many communities, infant mortality rates exceed those in developing nations. Nations like
"Striking disparities exist among the health of mothers and babies of different racial and ethnic backgrounds. Black children face the highest child mortality rate among racial/ethnic groups - more than 2 times higher than the rate for Asian children and 1.5 times higher than the rate for white children.i There are dramatic variations in key measures like well-visits for women and infants among different racial and ethnic groups as well as geographic areas.
Maternal Mortality and Severe Maternal Morbidity Are a Public Health Crisis
"Across
"Maternal mortality is also significantly higher in rural areas, where obstetrical providers may not be available,vi and delivery in rural hospitals is associated with higher rates of postpartum hemorrhage.vii March of Dimes will release a report in the coming weeks that will show these "maternity care deserts," where pregnant women face serious challenges in receiving appropriate care.
"Approximately 700 women die each year in the
"According to the
"Causes of maternal deaths include cardiovascular conditions, hypertensive disorders of pregnancy (preeclampsia/eclampsia), infection, hemorrhage, suicide and drug overdose. Identifying and treating medical conditions before, during and after pregnancy are essential to preventing maternal morbidity and maternal mortality, as part of the continuum of care for all women of childbearing age. This requires a commitment to high-quality clinical care and enhanced maternal quality improvement and safety initiatives in hospitals, particularly those that address disparities, structural barriers to care, differential care experienced by women of color, and provider implicit racial bias.xiv
"March of Dimes supports efforts to eliminate preventable maternal mortality and SMM and the unacceptably large disparities in rates experienced by black women. To achieve this, March of Dimes:
* Encourages every state to have a maternal mortality review committee that investigates each death of a pregnant woman or new mother to understand causes and recommend interventions for the future.
* Supports efforts to improve ways to collect data on maternal mortality and SMM, research into their causes and prevention, and promotion of proven ways to keep all mothers healthy.
* Supports ensuring access to inpatient obstetrical facilities and qualified obstetrical providers in rural settings.
* Supports state perinatal quality collaboratives working with hospitals to identify and review cases of SMM and implement hospital based quality improvement initiatives to improve care and promote patient safety.
* Supports efforts to ensure that all women have quality, affordable health insurance and health care to include but not limited to postpartum depression screening, mental health treatment,
"substance use treatment, affordable contraception, including long-acting reversible contraception (LARC), and access to health care providers who understand and meet their health needs before, during and after pregnancy.
* Supports improving the social and economic conditions and quality of health care at all stages of a woman's life.
* Encourages acceleration of policies and programs shown to provide preventive and supportive care for women during pregnancy, including group prenatal care.
The Preventing Maternal Deaths Act is a Critical Step Forward
"The state of maternal health in the
"The discussion draft of H.R. 1318, the Preventing Maternal Deaths Act, sponsored by Representatives
"project to help ascertain how best to address disparities in maternal health outcomes. Together, these provisions will help us obtain the information and recommendations we need to prevent women from dying or experiencing serious health consequences of pregnancy.
"Our nation cannot prevent maternal mortality if we lack data about where and why it takes place. This legislation will fill significant gaps in our current knowledge by ensuring we have nationwide data on maternal mortality rates as well as information about causes. It will provide states and tribes with new resources to gather information and ensure their maternal mortality review committees operate according to best practices. Finally, it will protect the privacy of women and their families by ensuring strong confidentiality processes are in place to prevent the unauthorized release of information.
"
"In conclusion, I would like to thank you,
* * *
Footnotes:
i
ii WHO. Trends in Maternal Mortality 1990-2015. Available at: http://www.who.int/reproductivehealth/publications/monitoring/maternal-mortality-2015/en/
iii
iv Creanga AA, Berg CJ, Syverson C, Seed K, Bruce FC, Callaghan WM. Pregnancy-related mortality in
v Callaghan WM. Overview of maternal mortality in
vi Faron, Dina. Maternal Health Care is disappearing in rural America.
vii Kozhimannil KB, Thao V, Hung P, Tilden E,
viii MMRIA. Report from Nine Maternal Mortality Review Committees.
ix Berg CJ, Harper MA, Atkinson SM, et al. Preventability of pregnancy-related deaths: results of a state-wide review. Obstet Gynecol 2005;106(6):1228-1234.
x MMRIA. Report from Nine Maternal Mortality Review Committees.
xi
xii
xiii
xiv Jain JA, Temming LA, D'
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