Maternal deaths are still high in the US and we know why
by Dr. Alan Kadish NMD
We mistakenly think that the US is one of the best health care systems in the world. Far from it in many areas of care. Maternal risk remains hight in the states and needs correction.
Maternal Rates of death
Lets take the issue of maternal death rates. You would think that after the thousands of years observing and having seen births that a safe childbirth would be a obvious outcome for most, and generally that’s the case. In the US the rate of maternal deaths is increasing.
The ” Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015” is a telling indictment of our health care system. The US is not making the expected progress of a so called first rate socioeconomic country. In fact were are ranked with some of the lowest 3rd word countries.
SOURCE The Global Burden of Disease 2015 Maternal Mortality study as published in The Lancet medical journal
To give you a sense of the numbers, it’s reported that 50,000 women are severely injured and ~700 mothers die per year in our country. A bit of a perspective, in the UK where they standardize care, their rate is ~1/3 of this number.
Key issues
The key is appears to be two principle and addressable issues,
1. Quick care of elevated blood pressure, which means consistent monitoring and treatment
2. Measuring blood loss, which can be as simple as a spreadsheet to measure the weight of saturated pads, etc. and know the amount of loss.
California, a different approach
In California they confronted the high mortality rate with a system of consistent care when addressing two of the high impact health issues, high blood pressure and blood loss. One of the keys, hemorrhage guidelines which were created by Dr. David Lagrew as part of Stanford’s California Maternal Quality Care Collaborative (CMQCC). Their rate of death due to hemorrhage went down ~66% with the institution of consistent methods of care. Is it working ?
See this graph:
Your state ?
Unfortunately not unlike many other things in the states, it depends on what state your in, what hospital system and of course your maternal care and other health factors. Click on your state in the image below to get their stats.
If you think you can evaluate a hospital system by its “ratings”, your clearly mistaken. The manipulation of the numbers into selective categories is well known among administrators as they address the need for reimbursement via the newer incentive based system by CMS.
If you want some slightly helpful information and I say this based on my own experiences, you might want to check the Compare Hospitals site . Interesting on the maternal charting it only references; “Percent of mothers whose deliveries were scheduled too early (1-2 weeks early), when a scheduled delivery was not medically necessary”, not maternal complications or death rates.
Take Homes for all Women:
- If you live in Louisiana, Georgia, and Indiana, which have the highest rates of complications and death, consider options to a safer facility out of state.
- Ask if the hospital is following the California Maternal Quality Care Collaborative (CMQCC) recommendations and talk to some of the nursing staff to verify that indeed they have a hemorrhage cart in the delivery rooms.
- Inquire if the facility is participating with the COUNCIL ON PATIENT SAFETY IN WOMEN’S HEALTH CARE and implementing their “safety tools”
- Want to really get the inside scoop , ask for their maternity statistics and see how they rank, assuming your able to get them.
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Alan Kadish
Dr. Kadish is an unusual physician often referred to as a “doctor detective”. His expertise is the evaluation and treatment of complex disorders, typically after other physicians and clinics have been stumped, is renowned. He provides care for all family members and has additional training in autistic spectrum disorders (ASD) and chronic complex diseases (focused on autoimmune and neurological conditions). If your wanting or needing some answers for your health issues call us at the Center of Health, 541.773.3191 .
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