HOUSTON (Jan. 30, 2020) — As the National Center for Health Statistics’ (NCHS) today released new maternal mortality data showing Texas’ maternal mortality rate was 18.5 per 100,000 live births in 2018 — higher than the U.S. statistic of 17.4 per 100,000 live births — experts from the Improving Maternal Health Houston (IMH) initiative emphasized that the incidence of maternal mortality and morbidity in Harris County remains too high and demands greater attention. A number of actions have been identified, such as a move to more reliable data compiled from patient medical records rather than administrative codes, as well as improving the continuum of care for low-income women.
NCHS data released today did not list data by city or county, existing research shows Harris County has one of the highest rates of maternal morbidity among metropolitan areas in the United States. Further, between 2008 and 2015, Harris County’s incidence of maternal morbidity increased 53 percent, compared with a 15 percent increase for Texas overall. (Source: Improving Maternal Health in Harris County: A Community Plan).
A collaboration of more than 100 leading maternal health care professionals and community advocates, IMH originated with a cornerstone of creating and implementing a model for more accurate data collection and improving the maternity health care infrastructure that serves women in Harris County.
“The death of a mother during pregnancy, childbirth or the postpartum period is a tragic loss that has an immeasurable impact on the family, community and society. The CDC’s National Center for Health Statistics public release of 2018 maternal mortality data is very important. In addition to being the first such release since 2007, it maintains focus on the unacceptable rate of maternal death in our state and country,” explained Dr. Carla Ortique, co-chair of IMH and Vice-Chair of the Texas Maternal Mortality and Morbidity Review Committee.
Dr. Ortique, an obstetrician with The Women’s Specialist of Houston at Texas Children’s Pavilion for Women, shared that due to reliance on vital statistics data, challenges continue to exist in identifying contributing factors and preventability of maternal death.
“Continued focus on improving data collection and standardization of the maternal death review process is essential to develop recommendations for the systems-level changes necessary to eliminate preventable maternal deaths as well as the racial, ethnic and socioeconomic inequities that exist in the maternal death rate,” she said. “The released data underscore the need to acknowledge the negative impact of implicit bias and racism on maternal health outcomes and engage all sectors to develop recommendations to foster meaningful policy and system-level changes.”
The IMH initiative has prioritized three efforts to improve the survival and wellness of pregnant women and mothers:
- Establish a voluntary, medical record-sourced data registry at Harris County-area hospitals where women deliver babies. Amassed differently than the NCHS statistics announced today — which are based on a “pregnancy status checkbox” marked on death certificates — the IMH data registry would record key medical data that will identify primary and secondary causes of death or near-death experiences. Leaders of the IMH initiative and physicians from area hospital systems are finalizing protocols for the registry that protect the privacy of the patient and collect the most consequential, uniform data from facility to facility.
- Implement the Healthy Women Houston pilot program, which aims to make Federally Qualified Health Clinics (FQHCs) providers of choice for women seeking obstetric care. Two Houston-based FQHCs — Avenue 360 and HOPE Clinic — are enhancing their maternal health services to offer a continuum of care that connects a woman’s care between her prenatal provider, the delivery hospital and post-birth care. Additionally, recognizing that stress and other social and economic factors can adversely affect a woman’s health, Healthy Woman Houston health workers assist pregnant women who experience challenges such as transportation, food or housing insecurity, which can exacerbate health issues and complicate pregnancy.
- Bring greater attention to how medical providers’ biases adversely affect the quality of care women receive. More African American women are affected by maternal mortality and morbidity than the total number of White and Hispanic mothers combined. The IMH initiative is working with organizations to help identify processes that might be inadvertently creating bias, map out coaching approaches to reduce the negative impact of bias and advocate for disaggregating data by race to achieve more unbiased patient care.
For more information about the Improving Maternal Health initiative, visit www.imhhouston.org.
About Improving Maternal Health
The Improving Maternal Health initiative addresses the various and complex drivers of maternal mortality and other adverse outcomes through a comprehensive, long-term strategy. The initiative is funded with support from Houston Endowment, Episcopal Health Foundation, Cullen Trust for Health Care and others, and includes more than 100 area maternal medical leaders and community leaders committed to increasing maternal survival and improving women’s pre- and postpartum wellness by shifting healthcare norms and societal attitudes. Learn more at www.imhhouston.org.
Cherri Carbonara, Carbonara Group, 832.473.6380