Nurse-midwife Karen Sheffield-Abdullah works for several weeks a year. She is a medical investigator with the North Carolina public health department.
Maternal mortality review committees look for clues to what contributed to the deaths and how they could have been prevented.
Almost all of the deaths of pregnant women in the U.S. were preventable in the most recent data released by the Centers for Disease Control and Prevention.
Between seven days and a year after delivery, more than half of the deaths occur.
She says that they are so focused. The mother is almost thrown out when the baby arrives. Like a peanut butter cup. The mom is holding the baby. You just discard the wrapper after removing it. The time after the baby is born is what we need to think about.
White and Hispanic women were most likely to die from suicide or drug overdoses, while Black women were more likely to die from cardiovascular problems. According to the CDC report, there are two conditions that occur disproportionately after the baby is born.
There are many weaknesses in the system of care for new mothers, from policies that strip women of health coverage shortly after they give birth to the fact that obstetricians are not trained to look for signs of mental trouble or addiction.
The problem is that the checkup is too late. She says that new mothers who died later missed this appointment because they had to return to work or care for other children.
Patients need to be referred to the appropriate follow-up care within one to two weeks after delivery.
Increased screening for depression and anxiety, starting at the first prenatal visit and continuing throughout the year after birth, is one of the CDC recommendations, as is better coordination of care between medical and social services.
Child protective services take the baby away when a parent's substance use problem gets so bad that the mother accidentally overdoses. It's possible to prevent deaths by having access to treatment and regular child visits.
He says the expansion of free health coverage through Medicaid is the most important policy change. Medicaid coverage for pregnant women expired two months after the baby's birth, forcing them to stop taking their medication or see a doctor because they couldn't afford it.
36 states have either extended or plan to extend Medicaid coverage to a full year after the birth of a child. In the past, the data showed that a third of pregnancies-related deaths occurred one year after delivery, but in this report, they jumped to more than half.
The executive director of the Maternal Mental Health Leadership Alliance doesn't know what to make of the situation. Mental health issues are the most common cause of maternal and child morbidity. We haven't had the will to take action.
Almost double the number of states that participated in the previous report were analyzed by the latest CDC study. The goal is to bring in more complete data from more states in the future with the help of the CDC.
Black women are three times more likely to die from birth-related problems than white women.
Many of the same advocates for better maternal care are dismayed by the recent U.S. Supreme Court decision.
Some women are finding it harder to get emergency care for a miscarriage due to the fact that Texas and other states have made it harder to get an abortion earlier in pregnancy. Even in cases of rape or incest, states are prohibiting abortions in young girls, who are at higher risk of death or serious injury from carrying a pregnant child to term.
Jameta Nicole Barlow is an assistant professor of writing, health policy and management at George Washington University. " Whether it's through policy, whether it's through your doctor, whether it's through your daily work experience, there's this acknowledgment that 'I don't own my body.' "
Barlow says that the mental health struggles women experience around pregnancy will only get worse because of this. She thinks the maternal mortality numbers will get worse before they improve.
She says that until we address what's happening politically, we won't help what's happening psychologically.
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