The death of a mother is a serious personal and societal tragedy. Maybe this is even more true when pregnancy — the process of becoming a mother — contributes to her death. As a husband and father of two, I can’t imagine anything that could sting worse. Beyond being my faithful friend and unflappable companion, my wife is my son’s world. I grieve to know that anyone has had to experience that sort of loss.
Fortunately, such tragedies are not common; unfortunately, they are becoming more so. Estimates from the Centers for Disease Control and Prevention suggest that deaths related to pregnancy in the United States have more than doubled over the past 20 years. Today about 22 in 100,000 live births result in the mother’s death. While that number appears small in respect to the number of overall births, consider that it is just as common as deaths from diabetes in the general population and breast cancer deaths among women. This increase in maternal mortality comes after the U.S. has enjoyed almost an entire century of pregnancy becoming safer and safer, thanks to better delivery and prenatal care. Idaho’s rate of maternal mortality has followed the same alarming trend as the rest of the country, with most recent numbers being near the national average.
This past summer, I spent my break from medical school as a research assistant trying to understand what state-level trends might explain the increase in maternal deaths. Researchers have many ideas about why this might be happening: obesity rates are rising, more women are delaying childbearing, chronic disease is more prevalent, fewer women have access to pregnancy care, and so forth. However, none of these hypotheses do a very good job at explaining the current trend.
To that end, whenever a woman dies who is or was recently pregnant, it is important to understand whether the pregnancy influenced her death. Was there proper medical care? Did pregnancy harm the mother’s health? Could her death have been prevented? The best way to answer these questions — and then devise strategies to prevent further deaths — is to establish state-level maternal mortality review committees. Such groups are typically made up of doctors, hospital administrators, public health officials, and community members. Almost 60 percent of states have them, including our neighbors Montana and Utah. However, Idaho does not, nor has it ever had one.
In 2008, a bill was introduced in the state Senate to create a maternal death review panel. It would not have cost Idaho nor any of its residents a cent, since the state branch of the American Congress of Obstetricians and Gynecologists agreed to donate the funds for the committee each year. But unfortunately, the bill failed. Since then, dozens more Idaho women have died in pregnancy. Idaho needs to know why its mothers die to learn how to prevent it from happening in the future; the state government just needs to gather the experts to do it. I urge you to contact your legislators and ask them to make the quick policy fix this important issue demands during this legislative session.
Daniel Nelson, of Nampa, is a graduate of Vallivue High School and a second-year medical student at the University of Michigan Medical School.