Editorial: Indiana maternal mortality rate improves with increased attention

The (Fort Wayne) Journal Gazette

Pregnancy can be a joyous time but also a dangerous one, particularly in the U.S. According to the Commonwealth Fund, American women have the highest maternal mortality rate among the world’s high-income countries.

That rate has been increasing since 2000, but Indiana received some good news last week with the release of the latest report of the Indiana Maternal Mortality Review Committee. Deaths among pregnant or recently pregnant women fell from 92 in 2020 to 80 in 2021.

It’s good news, but one year does not a trend make and, unfortunately, many of the same underlying issues remain. Committee members found 71% of pregnancy-associated deaths and 77% of pregnancy-related deaths were preventable, proving there’s still much to do as the state works further to reduce the deaths of expectant and recently pregnant women.

Pregnancy-associated deaths include any deaths within one year, no matter the cause, while pregnancy-related deaths include those “from a pregnancy complication, a chain of events initiated by the pregnancy or the aggravation of an unrelated condition by the physiologic effects of pregnancy,” the report said.

Prenatal care is the keystone of maternal death prevention. But just 47% of the Hoosier women reviewed by the mortality review committee entered into prenatal care in the first trimester of pregnancy, and 24% received no care at all.

Other factors affecting Indiana’s maternal mortality rate, the committee said, include drug use, which accounted for 28% of fatalities; a lack of hospitals with inpatient delivery services in 37 of the state’s 92 counties; and maternal mortality’s disproportionate effect on low-income women.

Despite fewer births overall, Black women in Indiana continue to have a higher maternal mortality rate, 73% higher in 2021 than their white peers. Black, non-Hispanic women constituted 13% of live births but had a mortality rate of 156.3 per every 100,000 births. In contrast, white, non-Hispanic women made up 72% of live births and reported a mortality rate of 90.76 per every 100,000 births.

Last year, Fort Wayne’s Healthier Moms & Babies released its Community Infant Mortality Report. It found 34% of almost 1,000 local anonymous respondents said they took some or none of their prescribed pregnancy medications, and many women skipped routine checkups that could’ve identified potential pregnancy risks.

“By transforming these challenges into opportunities for change, we can ensure that every baby in our community has the chance to celebrate many more birthdays,” Paige Wilkins, executive director of Healthier Moms & Babies, said in an opinion column we published last month.

During the 2023 legislative session, the state appropriated $225 million over two years to improve health outcomes. Prior to last year, Indiana’s county health departments had among the 10 lowest expenditures per capita in the nation.

In January, the Allen County Department of Health awarded 29 local organizations grants totaling more than $2 million to help meet the community’s health needs. In the area of “maternal & child health,” a core public health service area required of local health departments by the state, the county appropriated:

• $60,000 to A Mother’s Hope Inc. for housing, support and case management services for pregnant women experiencing homelessness.

• $60,000 to the Associated Churches of Fort Wayne & Allen County for the expansion and support of both A Baby’s Closet and Journey Beside Mothers programs that support low-income expectant mothers and families.

• $50,000 to Bridge of Grace Ministries for the expansion of services in child development and infant and childhood mental health.

• $110,000 for Healthier Moms & Babies to focus on improving mortality rates within vulnerable populations.

• And $50,000 to Lutheran Social Services Inc. for case management services assisting pregnant or parenting teenagers.

Good health ensures Hoosiers thrive. The state’s new health funding creates an opportunity to finally move Hoosier health metrics in a positive direction, and we applaud the Allen County health department for collaborating with existing agencies to provide targeted services rather than duplicating efforts as the community focuses on improving maternal health.

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