HJAR Mar/Apr 2020

36 MAR / APR 2020 I  HEALTHCARE JOURNAL OF ARKANSAS DIALOGUE COLUMN DIRECTOR’S DESK Arkansas’s maternal death rate is 44.5 per 100,000 live births, more than the national rate of 29.6, according to America’s Health Ranking’s 2019 Health of Women and Children Report. The World Health Organization (WHO) defines maternal death (or maternal mortality) as the death of a woman as a result of complications during, and following pregnancy and childbirth. The Arkansas Department of Health (ADH) is now establishing a Maternal Mortality Review Committee that will help create a better picture of what is causing those deaths, and how to best prevent them. TheWHO says 817 women worldwide die each day from preventable causes related to pregnancy and childbirth. In the United States, there were 700 deaths in 2017 due to pregnancy or delivery complications. Of those deaths, 60 percent were preventable, and 33 percent happened one-week to one- year postpartum. Severe bleeding and preeclampsia are some of the most common preventable causes of maternal death, as well as common drivers of maternity costs. Another national trend is a higher maternal death rate among African American women. That is especially true in Arkansas, where for every 100,000 live births, 76.3 African American women die, compared to 41.8 white women. There is also a higher chance of death as women age. As women defer childbirth until they are older, they are more likely to have underlying conditions that may be exacerbated by pregnancy. For every 100,000 live births, the maternal death rate is 23.9 for women age 15-24, 31.9 for those age 25-34, and 120.8 for those age 35-44. Arkansas has had between 36,000 to 40,000 live births each year for the past 10 years. Arkansas is 46th out of 50 states in terms of maternal death. In 2018, there were 36,800 live births in Arkansas, and provisional data show that 30 women died while pregnant or following birth, 15 during pregnancy, nine within 42 days following childbirth, and six between 43 days and one year following childbirth. For everymaternal death, there are an estimated 70 cases of near misses that represent severe maternal illness. Recommendations that arise from review of maternal deaths may help improve the health and outcomes of the near misses that severe illness represent. Arkansas is still trying to obtain a clear Addressing Maternal Mortality in Arkansas