Most maternal deaths are preventable

Arkansas has one of the highest maternal mortality rates in the United States. This problem isn’t limited to our state — the system is failing mothers across the country, especially in the South.

The most recent report from the Arkansas Maternal Mortality Review Committee (AMMRC) found that 94% of maternal deaths in Arkansas were preventable. But what does this prevention look like?

As an OB-GYN, I know firsthand that solving this crisis will require action from all parts of the health care system. Here are some interventions that have been proven to be effective:

Prioritizing early and consistent prenatal care. Consistent prenatal screenings and appointments are important to a healthy pregnancy. Missed appointments are associated with increased risk of serious health consequences. Increasing continuity of care (which means patients see the same nurse and provider at each visit), addressing systemic barriers such as long wait times, and introducing flexible scheduling and appointment reminder policies can help alleviate friction on the patient’s end.

Encouraging patients to continue care during the fourth trimester, which encompasses the first 12 weeks after birth, is crucial. According to the latest estimates drawn from the National Healthcare Benchmark Database, up to 57% of mothers do not attend a postpartum appointment.

Access to specialists and peers. Consultations with maternal fetal medicine specialists, doctors trained specifically in high-risk pregnancy care, make a huge difference for general OB-GYNs and their patients. Accessing peers and specialty doctors is harder for doctors in rural areas and other health care deserts, but telehealth networks have been found to support interprofessional collaboration without requiring the patient to travel.

To cover gaps in access to care, physicians can also partner with specialized community health workers, who help connect patients with resources, education and support.

Training doctors to screen beyond the physical. The maternal health crisis is also a mental health crisis. Mental health-related conditions are the leading cause of maternal deaths in the United States. According to the Policy Center for Maternal Mental Health, less than 20% of pregnant and postpartum patients are screened for mental health.

This can be addressed by training OB-GYNs to screen for signs of mental health conditions such as depression, anxiety, and substance use disorders and connect patients with resources that can help.

Sadly, the most statistically likely time a woman will experience intimate partner violence (IPV) is during pregnancy. In addition to posing a significant risk to the woman’s life, IPV is associated with delays in prenatal care, higher risk of preterm birth, and increased likelihood of substance use and poor mental health. To improve these conditions, medical professionals can be trained to screen for the warning signs of abuse during health care visits and learn how to safely intervene.

Data and awareness. You can’t fix a problem until you measure it. Continuing to pursue further maternal health reports and data will allow an even fuller picture of this crisis and may present new, unique solutions.

In the meantime, we can also work to spread awareness of the data we already have. In a study of labor and delivery personnel conducted by the AMMRC, less than 1 in 3 respondents knew the AMMRC report existed. Articles like this one and other awareness-building measures can help these data reach the medical professionals who need it most — and work toward a future where these preventable deaths are prevented.

Editor’s note: Dr. Yolangel Hernandez Suarez is executive vice dean of Alice L. Walton School of Medicine in Bentonville. The opinions expressed are those of the author.