(The Center Square) – Frequent review of Missouri’s maternal mortality rate is providing a focus on ways to address problems and implement solutions, including more focus on mental health care and tightening enforcement of seatbelt laws.
The agency’s Pregnancy-Associated Mortality Review Board published a report analyzing maternal mortality from 2017 to 2021. During the period, the pregnancy-related mortality ratio was 32.2 deaths per 100,000 live births. In 2022, there were approximately 22 maternal deaths per 100,000 live births in the United States, according to research from The Commonwealth Fund.
Black women in Missouri had 2.5 times the ratio of white women in the category, but it marked a decline from three previous reports by the group. COVID-19 infection was the cause of death in two of three pregnancy-related deaths in 2021.
“Highlighting the work of the PAMR Board through the dashboard and this thorough annual report allows our team and stakeholders a more effective tool to monitor progress as various evidence-driven initiatives are implemented statewide to address our unacceptable maternal mortality rates in Missouri,” Paula Nickelson, director of the Department of Health and Senior Services, said in a statement announcing the publication of the report.
Mental health conditions, including substance abuse, were considered preventable when listed as a cause in cases of pregnancy-related deaths, according to the report. Preventable mental health conditions contributed to 77% of all pregnancy-related deaths in the state. During the five-year period, 44% of pregnancy-related suicides occurred in 2020.
The report acknowledged challenges of examining small numbers of women and developing appropriate strategies.
“Maternal mortality in the state of Missouri is exceptionally complex,” according to the report. “It touches on the societal issues of health disparities, lack of access to care and the ongoing opioid epidemic. Seeking to understand this problem brings to light a variety of other concerns rooted in the systems intended to help.”
Four of the committee’s six recommendations for the legislature are approved or underway. They include funding for a statewide collaborative on perinatal quality and establishing and funding a perinatal psychiatric access program to assist healthcare providers in providing evidence-based mental healthcare.
They also recommended funding Medicaid expansion and a bill extending Medicaid coverage to one year for all conditions, even if the woman didn’t start treatments before delivery and is experiencing symptoms or problems during the postpartum period.
The board is recommending increasing the fine for a seatbelt violation from $10 to $60 by 2026. It also wants by 2026 a primary enforcement seatbelt law for all occupants, regardless of where they sit in the vehicle.
“We are expeditiously implementing the agreed-upon strategies to reduce maternal mortality with the funding recommended by the governor and appropriated by the general assembly,” Nickelson said. “It is reassuring that our state’s policymakers understand the gravity of this issue and were willing to take decisive action.”
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