BATON ROUGE, La. (BRPROUD) – Pregnant Black women in Louisiana are dying at about twice the rate of pregnant white women in Louisiana. Homicide was a top cause of pregnancy-associated deaths, according to a report from the state health department.
The Louisiana Pregnancy-Associated Mortality Review said that more white women gave birth than Black women, but Black women had the highest number of pregnancy deaths.
The report broke down maternal deaths in three ways:
- Pregnancy-related: a death during pregnancy or within one year from a complication in the pregnancy
- Pregnancy-associated, but not related: Death from a cause unrelated to pregnancy within one year of the end of the pregnancy
- Pregnancy-associated, but unable to determine relatedness: a death where the cause is not determined to be related or associated with a pregnancy
Dr. Veronica Gillespie-Bell, MD, MAS, FACOG is the medical director for the pregnancy-associated mortality review. She said the first thing is understanding that race is a social construct, not a biological condition.
“So if we take that and understand that as a social construct, how can we affect it socially? The first is addressing our implicit bias as health care providers and understanding how our bias will sometimes make us not deliver quality care for Black women,” she said.
She said that can mean a difference between life and death.
“And now we’re working on activities to make sure we’re ensuring equity and respectful care,” Gillespie-Bell said.
Some of the work is through the Safe Birth Initiative, which aims to provide a safe, equitable and dignified birth space for everyone in Louisiana.
“But equity is always baked into everything we do,” she said.
Forty-two hospitals are part of the program, including Baton Rouge General Medical Center, Oschner Baton Rouge and Woman’s Hospital.
The report found that more pregnant women died from accidental overdoses, homicides and car crashes than complications in pregnancy in the state.
More than 180 women died from pregnancy deaths between 2017 amd 2019 in Louisiana, according to a state health department report.
In the Greater Baton Rouge area, there were 29 pregnancy deaths. This region was the second-highest in the state. The most pregnancy-related deaths within the three-year period were in 2019, the report said. Seventeen women died that year alone.
What can cause a woman to die during pregnancy?
Out of the 182 deaths, LDH found, 44 were related to pregnancy, 114 maternal deaths were caused by other factors and the other 24 were undetermined.
Deaths related to pregnancy
Gilispie-Bell broke down the leading causes of death due to complications in pregnancy.
“Cardiovascular conditions means conditions that affect the heart – congestive heart failure is an example. Thrombotic events are blood clots that move to the lungs. Hypertensive disorders are elevated blood pressures,” she said.
Eighty percent of these deaths were considered potentially preventable. Gillispie-Bell said the point of health initiatives is to improve readiness, recognition and response.
“We work on severe maternal morbidity, which we know will help improve mortality. And we have seen a reduction in severe maternal morbidity because of these initiatives,” she said.
Because of Safe Births, health care providers will determine the risk of blood loss and hemorrhages during labor and delivery.
“So when we quantify, we’re able to actually determine how much blood loss is happening so that we can respond in a much, much quicker, quicker way and not wait until the patient is showing signs of loss of blood,” she said.
On the hypertension side, Gillispie-Bell said it’s about timely treatment. If a patient comes in with signs or symptoms of hypertension, their blood will constantly be checked.
“We’re assessing blood pressures, checking that second blood pressure within 15 minutes of the first blood pressure to confirm hypertension, and then treating within 60 minutes of that first blood pressure,” she said.
Preventing maternal mortality
The committee of doctors, domestic abuse specialists, addiction specialists and perinatal mental health providers who created the report found more than 464 recommendations to improve the outcome of maternal deaths.
“While communities, facilities, healthcare professionals, and policymakers working at each of these levels can use these recommendations to help inform and guide their efforts to improve maternal health outcomes, eliminating maternal deaths takes all of us,” the report said.
Gillispie-Bell said it’s important because, in Louisiana, there are many low-acuity facilities and maternity deserts where patients are having to go far to get care.
She said that healthcare providers need to act quickly and make sure they are doing everything they can when a patient comes in to receive medical care, especially if the patient is at risk for death.
Hospitals and birthing facilities are recommended to:
- Have better preparations for pregnancy conditions that could increase the risk of maternal deaths
- Improve care coordination
- Implement an approach that combines the post-partum and newborn checkups into one visit
- Schedule appointments for a postpartum visit before discharging the patient
Government officials can:
- Develop legislation to increase access to doulas and midwives for pregnancy-related care,
- Increase funding for providers who practice in rural areas, especially in maternity deserts
- Implement and financially support telemedicine systems to improve access to care for those living in maternity care deserts
Pregnant women and families are recommended to develop healthy eating habits and know when to seek help.
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