A report released Monday by the state’s Maternal Mortality and Morbidity Task Force found that drug overdoses were the leading cause of maternal deaths in Texas between 2012 and 2015, with opioids to blame for more than half of those.
The joint biennial report, completed by the task force and the Department of State Health Services, included in-depth case reviews of 89 of the 118 maternal deaths that occurred in 2012. The study of medical, autopsy, and other confidential records showed that 80 percent of the deaths were preventable.
“These findings illustrate the important need to change the way obstetric care providers and our patients look at the postpartum period,” task force chairwoman Lisa Hollier said in a news release Tuesday. “Women can benefit from a better understanding of potential complications and access to their care providers for services and supports tailored to a woman’s individual needs.”
Kori Eberle, program manager for the San Antonio Metropolitan Health District’s Healthy Start program supporting pregnant and postpartum mothers, said the issues highlighted in the report, including mortality rates among black women being significantly higher compared than those of white women and the problem of opioid abuse and addiction during pregnancy, have been a focus for Metro Health programs for the last several years.
“I think that this report just validates a lot of what we are already doing, and lets us know that we are on the right track in addressing” maternal mortality and morbidity locally, Eberle said.
The Healthy Start program focuses on reducing maternal and infant mortality in Bexar County, where the rate of mothers dying from causes related to pregnancy climbed from 6.8 deaths per 100,000 live births in 2005 to 41 in 2016, according to Metro Health data. The program provides case management, health education, and referrals for mental health services for pregnant women until the baby turns two years of age.
Improving infant and maternal mortality rates throughout the city is also included in the 2017-19 Metro Health Strategic Plan as a public health priority.
Eberle said that the focus of Bexar County’s maternal mortality and morbidity task force will be on addressing preventable deaths.
“When we look at some of the most common causes of pregnancy-related death, it includes hemorrhaging, sepsis, cardiomyopathy, and cardiovascular and coronary complications,” all of which may be preventable, Eberle said. “We need to make sure that we let individuals know that they are at risk, and how they are at risk, so that they can take steps to prepare themselves before they become pregnant.”
Helping women access treatment for mental health concerns and chronic health conditions such as diabetes, obesity, and hypertension, and helping them to make changes in their lives, will help to improve mortality rates, Eberle said, noting that maternal health is the joint responsibility of the individual, the system of care, and the provider.
The state report found that factors contributing to maternal deaths, whether associated with or related to pregnancy, were “a complex interaction of personal, provider, facility, systems and community factors.”
Since the state Maternal Mortality and Morbidity Task Force was established in 2013 to examine Texas’ mortality rate, new methods to calculate maternal death rates have been established to correct previous statistics that were found to be flawed due to poor tracking mechanisms and lack of consistency.
The World Health Organization defines a maternal death as one that happens during pregnancy or within 42 days of a pregnancy ending, but the state report found that most maternal deaths occurred after the 42-day standard.
To ensure accuracy of local data, Metro Health tracks maternal deaths for up to one year following a live birth, and has been doing so for the last several years in response to data trends and subsequent misinformation.
“There is a need for continuous quality improvement and review processes” for data collection and ensuring quality care,” Eberle said. “We have to address this and attack it from so many different standpoints if we are really going to drive the needle toward improvement.”