Trump Signs Historic Bill to Cut Maternal Mortality Rate

Marcia Frellick

December 27, 2018

President Trump has signed a bill aimed at reducing the United States' maternal mortality rate — the highest rate of all developed nations — after it passed by unanimous consent in the Senate.

In the United States, the maternal mortality rate is 26.4 deaths per 100,000 (about 700 per year). That rate increased 250% between 1987 and 2014, according to the Centers for Disease Control and Prevention (CDC).

The CDC estimates that 60% of the deaths are preventable.

The maternal death rate is more than three times higher for African American women than white women in the United States, according to the CDC.

The bill allows the Department of Health and Human Services to give $50 million in grants over 5 years so that all states can form maternal mortality review committees to investigate every pregnancy-related or pregnancy-associated death and then target ways to prevent others.

Lisa Hollier, MD, MPH, president of the American College of Obstetricians and Gynecologists (ACOG), said in a December 13 statement after the legislation passed the Senate, "Today marks a major step toward eliminating preventable maternal deaths in our country. ACOG is thrilled that the US Senate passed the bipartisan Preventing Maternal Deaths Act before the year's end. This landmark legislation has been a long-held goal for ACOG and is a crucial step to reversing our country's rising maternal mortality rate."

Last week, the Commonwealth Fund released a multinational report on women's healthcare that similarly found that US women had the highest maternal death rate compared with 10 other wealthy nations.

That report, authored by Munira Z. Gunja, MPH, the Commonwealth Fund's senior researcher in the Health Care Coverage and Access program, and colleagues, cited as potential contributing factors the lack of prenatal care and higher rates of obesity, diabetes, and heart disease.

The Commonwealth Fund's report also noted that the US cesarean delivery rate is among the world's highest, with 320 procedures per 1000 live births.

"In Norway and the Netherlands, C-sections are performed at about half the rate, with slightly more than 160 procedures per 1000 live births," the report states.

The president's signature, which came December 21, means some states would have investigational committees for the first time. Other states have already set up groups to reverse maternal mortality, and the money would boost their efforts.

Cindy Pearson, executive director of the National Women's Health Network, a consumer advocacy organization, told USA Today that the key thing as states investigate maternal deaths will be not to blame the mother, because too much blame has been directed to mothers who are older, are overweight, or have health problems.

"That does not in any way, shape or form explain the differences in rates in our community or racial disparities," she told USA Today.

WXIA-TV reports that Atlanta father Charles Johnson's efforts helped pass the bill. In 2016, his wife, Kira, died 12 hours after giving birth to their second son.

According to the report, Charles Johnson said his wife never missed a prenatal visit, and at each visit she received a great report and had a healthy delivery by scheduled cesarean delivery.

However, in the recovery room, Charles Johnson noticed blood in her catheter and brought it to the attention of medical staff. After a 7-hour delay in receiving an internal examination, Kira Johnson died of a hemorrhage.

Johnson told NBC the bill was "a monumental first step." He added, "For so long, this has been the country's dirty little secret. For so long, this was looked at as a 'women's issue,' and dismissed."

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