New report shows need for action to prevent pregnancy-related deaths as numbers increase

New data collected and analyzed by the Arizona Department of Health Services’ Maternal Mortality Review Program shows that people of color are experiencing pregnancy-related deaths at a disproportionate rate in Arizona and that mental health supports are critically needed in our state.

Findings in the report on maternal mortality paint a concerning picture of rising mortality rates among pregnant and postpartum people. The report provides a closer look at the factors, including systematic issues, that contributed to these deaths. The report calculates differences in deaths rates in two year measurement periods: 2016-2017 and 2018-2019.

Pregnancy-related deaths, which are deaths that occur during or within one year of pregnancy, caused by a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy, increased by 44 percent between 2016-2017 and 2018-2019. The report found the leading causes of pregnancy-related deaths were mental health conditions (32.6%), followed by cardiovascular conditions (20.9%), hemorrhage (16.3%), and infection (16.3%).

Pregnancy-associated deaths, which are deaths that occur during or within one year of pregnancy regardless of the cause, were found to have increased by 15 percent, from 2016 to 2019. 

Native American people had the highest pregnancy-associated mortality ratio at 233.9 deaths per 100,000 live births, followed by Black or African American people at 166.8 deaths per 100,000 live births. 

Through individual-level case reviews, the Arizona Maternal Mortality Review Committee determined approximately 90 percent of the 149 deaths reviewed were preventable. This data and key findings are available in the latest report on maternal mortality. 

Support for people after they have given birth is critical for improving outcomes. Mental health needs to be a focus when working with pregnant people. 

There are multiple ways health care providers can evaluate patients to help connect them with services as soon as a need is suspected. Encouraging patients to seek care and strengthening the postpartum care delivery system, as well as several other recommendations listed below, will have the most impact on improving the lives of patients and their families.

The Arizona Maternal Mortality Review Committee presented  44 recommendations and implementation strategies in their report for preventing maternal deaths in Arizona. These recommendations, paired with collaborative efforts from Arizona’s maternal health care providers and facilities, could improve maternal health outcomes and save lives in our state.

The MMRC’s top 10 recommendations for preventing maternal deaths call on statewide partners to:

Establish continuity of care for timely coordination among health care providers.

1. Adopt trauma and culturally-informed practices.
2. Increase access to high-quality mental and behavioral health services.
3. Expand insurance coverage for the range of maternal health services beyond one year postpartum.
4. Screen pregnant individuals and their partners for domestic violence, mental illness, Substance Use Disorder, and Adverse Childhood Experiences.
5. Increase provider education about the perinatal period.
6. Enhance access to the full range of reproductive health services.
7. Ensure facilities are prepared for obstetric emergencies.
8. Address access to care barriers related to income insecurity.
9. Increase patient education about substance use and misuse.

ADHS offers resources for pregnant people and families, including maternal mental health resources, the Women, Infants, and Children (WIC) supplemental nutrition program, and the Hear Her campaign, which shares info about possible pregnancy-related complications and how to be aware of issues in the postpartum period.