Moms are dying as Minnesota health panel dawdles

Published 6:40 am Tuesday, June 25, 2019

Star Tribune

Distributed by Tribune Content Agency, LLC.

The maternal mortality trend line in the U.S. is appalling. In 1987, there were 7.2 pregnancy-related deaths per 100,000 live births. In 2015, the death rate had climbed to 17.2.

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New American moms are more likely to die than their counterparts in Australia, Canada and European countries. Moreover, the U.S. appears to be the only industrialized nation where the maternal mortality is rising, reports the American College of Obstetricians and Gynecologists (ACOG).

Minnesota, a state home to world-class providers, ought to be leading the charge to rein in this public health crisis. Instead, a group of state experts, whose mission is to delve into Minnesota data and find ways to prevent these deaths, hasn’t met since spring 2017. The reason appears to be foot-dragging by the Minnesota Department of Health (MDH) in filling a job vacancy created when the group’s official coordinator retired.

That retirement came in June 2017. The position was finally filled in November 2018. But the group still hasn’t met, despite numerous e-mails from group members pleading with agency officials to meet. The group, known as the Minnesota Maternal Mortality Review Committee, had 12 members the last time it met. They included experts such as the University of Minnesota’s Katy Kozhimannil, a renowned maternal health researcher, and Dr. Beth Elfstrand, a respected Twin Cities physician who chairs ACOG’s Minnesota advisory council.

Minnesota is one of nearly 30 that have maternal mortality review committees. Members’ work is unpaid but crucial. They take a deep dive into vital statistics to identify deaths linked to pregnancy and childbirth. An average of 20 of these deaths happen annually in Minnesota, according to state officials.

This information isn’t just helpful on a state level. Compiling the information vetted by these committees on a national level, as a 2018 report did, yields a comprehensive look at factors driving the alarming U.S. mortality rate. The 2018 report, relying on information reported by nine states, estimated that about 50% of deaths were caused by hemorrhage, heart conditions and infection.

The authors also concluded that about 60% of the deaths were preventable. Patients lacked awareness about the warning signs of serious complications. Misdiagnosis and ineffective treatments by medical providers were contributing factors. The report highlighted worse outcomes in different racial groups. Regrettably, Minnesota was not one of the nine states that contributed to the report.

This week, state Health Commissioner Jan Malcolm told an editorial writer her agency is committed to reconvening and strengthening the group. The next meeting “will happen this fall,’’ she said. Malcolm, who was appointed in January 2018 and reappointed by Gov. Tim Walz, said the department is working to expand membership and bolster its focus on health disparities and on “morbidity” — the nonfatal health problems can affect a woman during and after pregnancy.

For continuity, those who previously served on the committee should stay on if they seek to do so. Communications about the work also needs to be better. There are insights for doctors and for policymakers. Could extending coverage for new moms enrolled in state medical assistance programs help reverse the grim mortality trend?

This committee’s work is vital, and the lag time between meetings has been unacceptable. Members will need to hit the ground running this fall.