Congress seeks better data sharing to trim maternal mortality

Lawmakers are trying address a deficiency of data when it comes to understanding an alarming spike in U.S. maternal mortality by enabling states to participate in nationwide information sharing.

The U.S. maternal mortality rate has more than doubled between 1987 and 2014, according to the Centers for Disease and Control and Prevention. More American women die from pregnancy-related complications than in most other developed countries.

Legislation passed by the Senate health committee and a discussion draft version in the House would provide federal funding for states to create maternal mortality review committees (MMRCs) to better understand maternal complications and identify solutions. Currently, MMRCs do not exist in 15 states.

“We need to figure out what’s going on—and that requires collecting data to identify the factors that are causing young mothers to experience life-threatening health issues,” says Sen. Heidi Heitkamp (D-ND), who co-sponsored the Maternal Health Accountability Act with Sen. Shelley Moore Capito (R-WV).

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The east front of the Capitol building stands in Washington, D.C., U.S., on Monday, Jan. 3, 2011. President Barack Obama and Democrats are preparing to confront a strengthened Republican opposition to tax, spending and immigration priorities when the 112th session of Congress convenes this week after Democrats lost control of the House during midterm elections. Photographer: Andrew Harrer/Bloomberg

“Congress has delayed action on this life-and-death issue for far too long, and my bipartisan bill would help facilitate stronger, safer and healthier pregnancies by investing in cutting-edge research, beefing up information sharing and giving physicians and providers the tools they need to improve the patient experience,” Heitkamp adds.

The American Hospital Association supports the Maternal Health Accountability Act (S. 1112), as amended, as well as the Preventing Maternal Deaths Act of 2018 (H.R. 1318) sponsored by Reps. Jaime Herrera Beutler (R-Wash.), Diana DeGette (D-Colo.) and Ryan Costello (R-Penn.).

“While some states and cities already have established MMRCs, having participation by all states will allow for the collection of additional data that could result in greater understanding of the causes of maternal mortality and ways to improve treatment,” the national organization for hospitals wrote in letters of support to members of Congress.

According to Stacey Stewart, president of the March of Dimes, MMRCs are interdisciplinary groups of local experts in maternal, infant and public health that come together to investigate cases of maternal death, identify system-wide factors that contributed to the mortalities and develop recommendations to prevent future cases.

“MMRCs are unique in that they identify solutions—not just collect the data—that are targeted to the needs of pregnant women and mothers in specific states, cities and communities,” testified Stewart before the House Energy and Commerce Subcommittee on Health. “Our nation cannot prevent maternal mortality if we lack data about where and why it takes place.”

According to the CDC, MMRCs are best positioned to comprehensively assess maternal deaths and identify opportunities for prevention. While most of these groups of local experts identify cases by linking death certificate and birth certificate or fetal death records, MMRCs also have access to additional information on maternal deaths such as medical and social records that allow a deeper examination of the processes and factors leading to the death than what is possible from vital registration information alone.

Stewart made the case that the Maternal Health Accountability Act and Preventing Maternal Deaths Act will “fill significant gaps in our current knowledge by ensuring we have nationwide data on maternal mortality rates as well as information about causes.”

In addition she testified that the legislation will “provide states and tribes with new resources to gather information” while ensuring their MMRCs “operate according to best practices” as well as “protect the privacy of women and their families by ensuring strong confidentiality processes are in place to prevent the unauthorized release of information.”

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