Commonwealth’s Fund Reports Addresses Maternal Mortality

A pregnant woman’s death is often determined by her race as well as the state or country in which she resides.

Maternal mortality and maternity care in the U.S. have become heavily scrutinized over the past several years. Close to 700 Americans die annually from pregnancy-related causes, with the maternal mortality rate being higher in the U.S. than in any other industrialized country. A pregnant woman’s risk of death is often determined by her race, and also, often the state or country in which she lives.

The Commonwealth Fund’s recent report, Maternal Mortality and Maternity Care in the U.S. Compared to 10 other Countries, is a must-read. The applicable definition of maternal mortality is specific: death while pregnant or within 42 days of the end of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. Among the takeaways:

  • The U.S. has the highest maternal mortality rate among developed countries, 17.4 deaths per 100,000 births. By comparison, Canada and the United Kingdom had 8.6 and 6.5 deaths, respectively.
  • In the U.S., roughly 30 percent of pregnancy-related deaths occur during pregnancy, while:
    • 17 percent of deaths occur on the day of delivery, and
    • 52 percent occur after delivery, or postpartum.
  • Mortality rates in the U.S. are especially high for women of color, and as much as two to three times higher than those of other populations:
    • The number of deaths per 100,000 births for Black, non-Hispanic women in 2018 was 37.1; it was 14.7 for white mothers. Hispanic women had the lowest mortality rate, at 11.8.
    • However, in some cities and rural regions of the U.S., the numbers are even higher:
      • Alabama: 36.4
      • Arkansas: 45.9
      • Kentucky 40.8
      • Washington, D.C.’s mortality rate is 33, but 59.7 for Black women.
  • Concern exists regarding how much these numbers will increase during COVID, especially with so many patients opting to avoid obtaining care outside of the home, when possible.
  • Under the Patient Protection and Affordable Care Act (PPACA), Medicaid is required to pay for midwives, but such care is often not accessible. The reasons vary, from state variations in scope-of-practice rules for healthcare practitioners to low reimbursement rates for midwives and payment parity.
  • Although a large share of its maternal deaths occur post-birth, the U.S. is the only developed country not to guarantee access to provider home visits or paid parental leave in the postpartum period.

The Commonwealth report is a powerful read, and accessible at the organization’s website: www.commonwealthfund.org.

Limited availability of robust prenatal health programs in some regions is another factor to impact maternal mortality. Many rural communities have lost their OB units through hospital closures; more than 100 such hospitals have closed in recent years, with another 20 percent being under scrutiny. Patients end up having lengthy journeys to access care, often with fatal consequences.

A recent Monitor Mondays Listeners Survey asked listeners whether their organizations had expanded maternal health beds or services over the past year. The survey responses varied and appear here.

Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning healthcare industry expert. She is the esteemed author of books, articles, white papers, and knowledge products. A subject matter expert on the Social Determinants of Health, her latest books, The Essential Guide to Interprofessional Ethics for Healthcare Case Management and Social Determinants of Health: Case Management’s Next Frontier (with foreword by Dr. Ronald Hirsch), are published through HCPro. She is a panelist on Monitor Mondays, frequent contributor to Talk Ten Tuesdays, and member of the RACmonitor Editorial Board.

Related Stories

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Frank Cohen shows you how to leverage the Comprehensive Error Rate Testing Program (CERT) to create your own internal coding and billing risk assessment plan, including granular identification of risk areas and prioritizing audit tasks and functions resulting in decreased claim submission errors, reduced risk of audit-related damages, and a smoother, more efficient reimbursement process from Medicare.

April 9, 2024
2024 Observation Services Billing: How to Get It Right

2024 Observation Services Billing: How to Get It Right

Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.

March 21, 2024
Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.

February 22, 2024
Mastering Healthcare Refunds: Navigating Compliance with Confidence

Mastering Healthcare Refunds: Navigating Compliance with Confidence

Join healthcare attorney David Glaser, as he debunks refund myths, clarifies compliance essentials, and empowers healthcare professionals to safeguard facility finances. Uncover the secrets behind when to refund and why it matters. Don’t miss this crucial insight into strategic refund management.

February 29, 2024
2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

HIM coding expert, Kay Piper, RHIA, CDIP, CCS, reviews the guidance and updates coders and CDIs on important information in each of the AHA’s 2024 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.

April 15, 2024

Trending News

SPRING INTO SAVINGS! Get 21% OFF during our exclusive two-day sale starting 3/21/2024. Use SPRING24 at checkout to claim this offer. Click here to learn more →