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Maternal mortality: A problem with solutions

Rates of maternal mortality are too high in the U.S. and too high in Philadelphia. There are solutions to this problem.

Rates of maternal mortality (deaths within one year of the end of a pregnancy) are too high in the United States and too high in Philadelphia. There are solutions to this problem.

There are few surprises in the Philadelphia report. Maternal mortality is marked by disparities and is correlated with poverty, poor physical health, and behavioral health problems including substance abuse and exposure to intimate partner violence. The interventions recommended by the committee therefore turn on increasing access to needed services, including home-based care that is coordinated with medical and social services, connecting health institutions' electronic medical records system so that clinical records and laboratory test results can be shared by all potential providers, training of emergency responders, provision of long-acting reversible contraception and access to postpartum tubal-ligations, support for women exposed to intimate partner violence, and treatment for mental health problems and substance abuse. The report contains recommendations for changes to state laws that will make surveillance of the problem easier and more likely to yield information that can be translated into successful interventions.

"Maternal Mortality in Philadelphia, 2010-2012," challenges the city, state, and health-care providers to take small steps that will yield results. Boiled down to its essence, the report wants the state and city to make the gathering of information effective and ongoing, and to make changes in the laws that will enable this to happen. It asks that an effort be made to provide coordinated services through the sharing of patient information. And it asks that professionals providing care work together to develop interventions that unite medical, social, and behavioral health services. This report is a template not just for Philadelphia, but for the nation. At present, the United States is 33rd in maternal mortality out of 179 countries surveyed – and it has the highest death rate in the developed world.

Can't we do better?

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