Why is the maternal mortality rate so high in Louisiana?

There are many causes for Louisiana rates and the national crisis, say public health and policy experts.

“Race is a social construct, it is not a biological condition,” said Veronica Gillespie-Bell, medical director of the Louisiana Perinatal Joint and Pregnancy-Related Mortality Review and an obstetrician at Ochsner Health. To say “because we have a lot of black people in Louisiana, so our results are bad” is out of context.

Cassidy, one of four doctors serving in the Senate, admitted in an interview that several causes of high maternal mortality rates were reported in his state, including racial bias, high rates of preeclampsia in black American women – a condition of high blood pressure that causes maternal mortality. Around the world – and it is difficult for women, especially in rural areas, to access medical care easily and quickly.

The related mother act proposed by her, S. 801 (117)Co-financed by Sen. Maggie Hassan (DN.H.), addresses some access issues for mothers by requesting Medicare and Medicaid recommendations to remotely monitor blood pressure, glucose and other health metrics. Cassidy also funded a bill called the late MP John Lewis. S. 320 (117)The law was signed this March, To study racial health inequality.

Cassidy also argued that the state definition of maternal mortality affects its consistently high rates.

“Sometimes maternal mortality ranges from birth to one year and can involve the killing of someone by her boyfriend,” Cassidy said. “In my opinion, it is better to limit your explanation to what is perinatal, if you will – time before and after childbirth.”

Louisiana uses the broad definition of maternal mortality that states have gradually adopted in recent years as the CDC has expanded its analysis through the Pregnancy Mortality Surveillance System. The states, the federal government, and the World Health Organization have traditionally defined maternal mortality as any death caused or related to pregnancy or childbirth within 42 days of termination of pregnancy. Louisiana has extended this to one year after pregnancy or childbirth and includes what it calls “pregnancy-related deaths” that are not actually caused or related to pregnancy.

Most states have actually switched to mortality monitoring within a year and are beginning to include broader definitions of pregnancy-related mortality, said Ellen Pliska, senior director of the Association of State and Territorial Health Officials, Family and Child Health.

“It’s bigger than just health,” Pliska said. “Until recently, there were many health issues such as sepsis, or infection, cardiovascular problems, or bleeding. We begin to see – and for quite some time now – that there are things that are not just medical that often lead to this untimely death.

This could mean that states continue to have higher mortality rates. Since the CDC introduced its oversight system, the country’s maternal mortality rate has been steadily rising from 7.2 deaths per 100,000 in 1987 to 17.3 deaths in 2017. But the agency says the reasons for the increase are unclear and at least part of the trend is related to better data. .

Louisiana was an early adopter during this transition period. Thirty-six states and the District of Columbia require officials to investigate pregnancy-related deaths, but only nine states and the District of Columbia require officials to consider racial inequality and equality in their review. Analysis of the Gutmacher Institute. Louisiana is one of them.

This means that death from a firearm within one year of the onset of pregnancy is considered maternal death, along with overdose, car accident, and suicide death. Maternal health experts, such as civil servant Gillespie-Bell, espouse this broad definition as a holistic approach that takes into account factors such as food insecurity, workplace conditions, economic stability, and family dynamics. In a Gillispie-Bell co-authored report, homicides among pregnant women were 16 percent higher than among non-pregnant women in 2018-2019.

“We always think of pregnancy as the time when someone is pregnant and then six weeks later it looks like a pumpkin,” said Gillispi-Bell. “The period before they get pregnant and the period after pregnancy is really when we have time to get involved and do things that will help us have a healthier pregnancy or reproductive planning before pregnancy.”

Louisiana began counting the broader causes of death during one year of pregnancy in 2016 when the CDC and the American College of Obstetricians and Gynecologists recommended a broader explanation of what constitutes maternal death. According to data before the change, Louisiana is still a relatively low place among the states in the country. That death does not significantly change the picture of Louisiana’s maternal mortality trends, but it does give health care officials a “broader picture” of the challenges facing new or expectant mothers, Gillispi-Bell said. “It’s less about what happens to the patient sitting in my office and more about what happens in their environment,” he said.

On the question of how maternal mortality rates may be affected by the probable probability of the abolition of the Supreme Court Vs. Rowe WadeFederal abortion advocate Cassidy denied the risk.

“If we use abortion to limit maternal mortality, it’s a strange way of approaching the problem,” the senator said.

A more holistic definition of maternal mortality does not mean that problems in the health care system are not the main driving force behind the untimely death of mothers in Louisiana and the country, said Gillespie-Bell.

“There are two things that always lead to inequality. “It’s going to be systemic racism – the historical processes and policies that have taken place that liberate black and brown people – and the second part of that will be implicit bias,” Gillispi-Bell said. “Black and brown individuals do not always receive the same quality of care in the health care system as their white counterparts.”

Why is the maternal mortality rate so high in Louisiana?

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