A bill to better track the deaths of women who were pregnant, or pregnant within a year prior to her death, passed the Georgia Legislature and awaits the governor’s signature.
Sponsored by state Sen. Dean Burke (R-Bainbridge), SB496 requires a medical examiner’s inquiry when a pregnant female dies during pregnancy, or if she dies up to a year after giving birth. It was sent to Gov. Brian Kemp on April 7 for his signature.
Georgia has a Maternal Mortality Committee to tackle the issue of maternal deaths but has struggled with having incomplete data because the cause of death is unknown or not listed in official records. SB496 improves collection of data connected to the death of pregnant women.
Dr. Chadburn Ray, an obstetrician-gynecologist at Augusta University Health, is a member of the committee and helped Burke write the new legislation.
“Most states use up to a year postpartum because we see women that have something happening during the pregnancy, that gives them a significant amount of disease state, for example, a prepartum, or postpartum cardiomyopathy,” he said. “They might ultimately die from that disease later on, but it was exacerbated or caused by the pregnancy.”
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The Centers for Disease Control and Prevention reviewed data from 14 Maternal Mortality Review Committees in the U.S. collected from 2008 through 2014. It found:
-Approximately one in three deaths among women during or within a year of pregnancy were pregnancy-related.
-Pregnancy-related deaths occurred during pregnancy, delivery, and up to a year postpartum.
-Leading causes of pregnancy-related deaths varied by race/ethnicity.
– Two out of three deaths were determined to be preventable.
Ray said, on average, there are between 700 and 1,000 pregnancy related deaths in America. Requiring the autopsy will mean more complete data on deaths that may otherwise not be determined to be pregnancy related.
“If we don’t have a postmortem exam, sometimes we are guessing. We’re not doing the counting just to count, we’re doing the counting because we want to know what women are dying, are they dying from something preventable,” he said.
He said the expanded data, in and of itself, will not reduce maternal mortality ratios. What it will do is provide doctors information on what they should monitor in their pregnancy patients.
This more complete snapshot of women’s health during pregnancy can be particularly vital for black women.
“Women of color, so Black, non-Hispanic women, are more likely to die than White women. That is the same in Georgia as it is for every other state. That’s data driven. The next piece of data that is extremely helpful for us is to say, when’s the most dangerous time in pregnancy. We know that black women are more likely to die in the postpartum period. At one point in time, our leading cause of death was hemorrhage. Then it went to venous thromboembolic events, like blood clots that are going to the lungs. Currently, it is of the six most common reasons why women die. They’re all cardiovascular related,” said Ray.
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Some women may not even realize they have a medical condition, or a pre-disposition to developing one, because of a lack of access to basic health care.
Ray said that’s one of the reasons he and his partner began a cardio-obstetrics clinic.
“We targeted specifically women who had hypertensive disease during the pregnancy, whether it be preeclampsia, or if they just had high blood pressure. And we built some capacity for them to be seen postpartum by cardiologists. We had never been able to do that before. So, we had our postpartum women, this is the demographic we wanted, in the time we wanted, for the disease state we wanted,” he said.
Ray said something that can help pregnant women is the state legislature has expanded postpartum Medicaid coverage from six months to 12 months. That means access to care, even specialty care like cardiology, during what can be the most critical time for women.
“You don’t get healthier when you’re pregnant. Pregnancy is a dangerous time for a woman, if you already have some underlying disease,” he said.
The full text of SB496 is available at: https://www.legis.ga.gov/legislation/62024
Dana Lynn McIntyre is a general assignment reporter for The Augusta Press. Reach her at dana@theaugustapress.com
