The numbers tell an important story.
Over the last two decades, maternal mortality rates have declined around the world, but in the U.S., more than 700 women die each year as a result of pregnancy or delivery complications. This is a 50% increase over the same time period.
And the data is worse for women of color.
Pregnancy-related mortality varies significantly by race, with 13 deaths per 100,000 births by white women and 42.8 deaths per 100,000 births by Black women, according to the Centers for Disease Control and Prevention (CDC).
Maternal mortality and specifically how it affects Black women was a focus of the recent Women’s Health Community event in Hartford. The event included a viewing of the documentary “Aftershock,” which documents the tragic and preventable deaths of two women after giving birth, and a conversation with experts about the maternal health crisis. More than 300 people attended the event.
Staging such events is important so healthcare providers can “come together with the community to solve this problem,” says John Santopietro, MD, Hartford HealthCare senior vice president and physician-in-chief of the Behavioral Health Network. Multiple organizations were represented throughout the day, providing information on varied needs, issues and services, he says.
Hartford HealthCare has made addressing this issue a priority, says Elizabeth Deckers, MD, director of maternal quality and safety at Hartford HealthCare.
“We have a standardized approach to obstetric care that includes multidisciplinary care teams and standardized approaches to the care of obstetric emergencies such as severe high blood pressure and bleeding after delivery,” Dr. Deckers says. “Another example is collaborative approaches with other specialists such as a new Hartford Hospital program partnering with the HHC Heart & Vascular Institute for postpartum management of women who develop hypertension during pregnancy.”
What is Hartford HealthCare currently doing to address maternal mortality?
Education
- Colleague training and patient education
- March of Dimes Implicit Bias Training for colleagues
- Internal viewing of “Aftershock”
- Respectful care and implicit bias training, now part of new nurse onboarding. Respectful Maternity Care emphasizes the fundamental rights of women, newborns and families, promoting equitable access to evidence-based care while recognizing unique needs and preferences.
- Inclusive conversations to encourage respectful dialogue, leading to deeper understanding and a stronger sense of community. These are facilitated conversations among colleagues.
Patient Advocacy & Engagement
- Development of a Patient Advocacy Kit to provide patients and others with the knowledge, skills and tools to advocate for their health and care.
- “Save Your Life” brochure, created by the Alliance for Innovation on Maternal Health, to provide information on urgent maternal warning signs.
- Patient Family Advisory Council providing direct input on Hartford HealthCare policies, programs and practices affecting patient experience.
Community Engagement
- Stronger Families Stronger Future. Women’s Ambulatory Health Services at Hartford Hospital, which serves a vulnerable patient population, is using a Stronger Families Stronger Future grant to address their needs during pregnancy and early childhood.
- Community partnerships
- Women’s Health Community Event
Data Collection
- Equity Integration Project dashboard. As part of HHC’s engagement with Just Health Collective, equity projects have been supported across the system and work is underway on a maternal health outcomes dashboard stratified by race and zip code.
- Screening for social determinants of health in the electronic medical record. Social determinants of health are the conditions and environments where people are born, live, learn, work, play, worship and age, and they affect a wide range of health and quality-of-life outcomes and risks.
The recently announced Fetal Care Center, a collaboration between Connecticut Children’s and Connecticut Children’s Pediatric Care Alliance with Hartford HealthCare, treats mothers with babies who have been identified as high risk for serious birth defects or health conditions who may need advanced care in utero and soon after delivery. It is just one of 15 centers in the country.
The Pediatric Care Alliance brings together experts at Connecticut Children’s and Hartford HealthCare to focus on maternal, infant and child health.
“We are looking to find more ways to help with the disparities that we see,” says Daileann Hemmings, MSN, RN, Hartford Hospital’s program director for maternal health equity.
After watching the documentary at the Hartford event, attendees were asked what they were feeling, Dr. Santopietro says, noting, “Anger and sadness were at the top.” The next step is to convert those feelings into action. “This gathering was just that,” he says.
In addition to medical treatment, HHC has implemented “training for colleagues about implicit bias and the impact of systemic racism on the Black maternal health crisis,” Dr. Deckers adds. “We are constantly working to raise awareness about health disparities and seek solutions.”