New Report Issues Critical Recommendations to Help

New York, NY – A new report outlines steps health officials can take to reduce the number of maternal deaths in New York State, which ranks among the worst in pregnancy-related mortality in the nation. The US ranks behind 40 nations in maternal death, yet spends more on maternity care per birth than any nation in the world. The most common causes of death during or shortly after childbirth include embolism, hemorrhage, pregnancy-induced hypertension, and infection.  It is estimated that 40 percent or more of these deaths are preventable.  Recent statistics also reveal alarming disparities in terms of race. Nationally, pregnancy-related mortality rates are three times higher for Black women compared to white women, and in New York City, seven times higher. 

The report, Maternal Mortality in New York: A Call to Action – Findings and Priority Action Steps, released by The New York Academy of Medicine (NYAM), is the result of a 2010 conference on the unusually high maternal mortality rate, during which local and state health officials met with medical professionals, community leaders, and researchers committed to reversing the trend of these deaths. Above all else, the report calls for greater public awareness about the changing face of pregnancy in New York; there are more older women, more women who are overweight and obese, and more women with chronic health conditions giving birth today. According to participants at the symposium, this has resulted in an increased number of complicated pregnancies without a corresponding shift in the general understanding about and modification of systems to manage these pregnancies adequately.

Building on the recommendations from the meeting and subsequent consultations with professional and policy leaders, the report calls for:

• The development and implementation of a system that reports all maternal deaths occurring in the state each year. This critical information, combined with a consistent approach to chart and on-site reviews, will help us better understand maternal deaths before, during and after delivery so that we can design community-based interventions to reduce them.

• For primary care providers to play a critical role in ensuring that pregnant women in their practice with identified risk factors are linked to the appropriate level of specialty care during their pregnancy and that hospitals where delivery is planned have the information they need about each woman. Patients need to fully understand risk factors so that they can make informed decisions about becoming pregnant; they must communicate these risk factors to providers who may not know them if there is an emergency. Existing regional systems established by the state to assure that the appropriate level of care is available to newborns need to be reviewed to assure that high-risk pregnant women can deliver at the hospitals with the necessary specialty expertise, facilities, and equipment.

• The implementation of better  hospital screening systems to identify high-risk pregnant patients as soon as they arrive for care and enter them into a system of case management that addresses potential medical and surgical risks. Women at highest risk are often those in labor who seek care at a hospital that has had no previous contact with them, even if the woman has been receiving appropriate prenatal care. While great strides have been made to manage the medical and surgical complications that may arise, more can be done to ensure that these are standardized and implemented throughout the state.

• Active and strong leadership by the State Health Department with the health care community to build consensus on clear goals and priorities for statewide action and develop a mechanism to assure the coordination needed to turn the good work being done on this issue by many talented and committed individuals and organizations across the state into concrete strategies with a specific timetable to prevent unnecessary maternal deaths.

• A web-based “Pregnancy Health Record” must be designed and made available to all pregnant women as soon as the pregnancy is confirmed.  This record should be able to be conveniently carried by the woman and, subject to appropriate confidentiality agreements, available for use (reading and recording) by all practitioners providing care during the pregnancy, delivery, and post-partum period. Very much like the classic Children’s Immunization Card, it can be retained throughout the reproductive life of the woman. The card should be capable of summarizing health status and pregnancy-related risks and flagging any chronic conditions, medications being taken and special needs she may have for all providers and hospital staff. By being web-based, the card’s use is not restricted to the IT system of a particular institution (as with most “smart cards”) and could help better integrate primary and hospital care, improve continuity of care, flag high risk patients in emergency situations, and increase patients’ understanding of their own risks.

“Putting these recommendations into action, especially during a time of difficult budget decisions, requires government and professional champions to implement the programs, and increased public awareness of the problem and the solutions,” said Dr. Jo Ivey Boufford, NYAM President. “The time is right to reduce the unacceptably high rates of maternal death in New York State.”

Posted on January 18, 2011

 Print   Subscribe

Contact:
Andrew J. Martin
Director of Communications
The New York Academy of Medicine
1216 Fifth Avenue
New York, New York 10029
212-822-7285
amartin@nyam.org

Press Release Archive