California Curbs Mothers Dying During Childbirth

July 26, 2017

Women giving birth in the US have a much greater risk of dying compared to other well-off nations and the related problems in the US have been growing. A mother can bleed to death in childbirth within minutes.

The American health care system handles difficult pregnancies with an astonishing lack of preparedness. Birth can be perilous but the deadliest pregnancy complications are survivable when hospitals are prepared.

Ten years ago, California wanted to halt the death of women bleeding from childbirth – their maternal mortality rate is now an astonishing third of the American average.

The California Maternal Quality Care Collaborative (CMQCC), is groundbreaking in how it makes births safer for mothers. CMQCC was conceived in 2006 at Stanford, when California’s maternal mortality rates had doubled.

CMQCC collects data about maternal health, focusing on the difficulties that can be averted during childbirth while engaging and assisting all participants to follow life-saving protocols.

Preeclampsia (pregnancy-induced severe high blood pressure) and hemorrhage were the most regular, and avertable, causes of death. Recently, they have been supplanted by problems including opioid addiction and heart disease.

The US was one of only 13 countries where the maternal death rate has increased since 1990. Maternal mortality (defined as during pregnancy to 42 days postpartum) rose by 27% from 2000 to 2014. The OECD reports that this is over three times the rates in the UK, and eight times the rates of Sweden, the Netherlands, and Norway. According to the CDC Foundation, 60% of these deaths are preventable.

There are multiple reasons for the uptick. First, there is a decline in access to contraception and abortion in sections of the US, which causes an increase in unplanned and sometimes dangerous pregnancies. Second, an increase in Cesareans, which can be and life-saving for mother and child in certain circumstances, can also cause complications with future births.

Finally, US policies and funding focuses on infants, not mothers. For example, Medicaid only covers women during and shortly after their pregnancy.

By 2013, California made great progress, combatting the maternal death rate to a third of the US rate.

CMQCC created free, downloadable “toolkits,” evidence-based guidelines that a hospital can use to plan and manage deadly childbirth complications. The “hemorrhage cart” helps healthcare organizations and hospitals develop methods for recognition and team’s rapid response to hemorrhage.

The toolkits have been very popular and downloaded more than 24,000 times. Over 200 of California’s 243 maternity hospitals are working with CMQCC.

California’s big corporations and insurance organizations also partner with CMQCC, because making births safer saves them money. They also assist with advocacy to the hospitals and health care organizations.

Sean Domnick is an attorney that is well versed in the risks women have suffered due to negligence and the lack of attention to issues related to pregnancy and childbirth.  He has extensive experience representing women in cases of medical malpractice and medical misdiagnosis and commented, “California should inspire the rest of the country to take proactive measures to prioritize the healthcare needs of women.  We must ensure that childbirth options in this country offer the safest experience for both mothers and babies and take initiatives to prevent these family tragedies.”

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Domnick Cunningham & Whalen

Domnick Cunningham & Whalen

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