Maternal Mortality and Morbidity Task Force

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Maternal Mortality Rate by Race-Ethnicity, Texas 2007-2011 Maternal Mortality Rate by Race-Ethnicity, Texas 2007-2011.png
Maternal Mortality Rate by Race-Ethnicity, Texas 2007-2011

The Maternal Mortality and Morbidity Task Force was started by the Department of State in 2013 to help reduce maternal death in Texas. The task force and DSHS must submit a joint report on the findings of the task force and recommendations to the governor, lieutenant governor, speaker of the House of Representatives, and appropriate committees of the Texas Legislature by September 1 of each even-numbered year, beginning September 1, 2016. [1] The maternal mortality ratio (MMR) for the state of Texas was concluded to be the highest in the developed world in 2016, with the maternal mortality rate (MMRate) of the state surging beyond the poor MMRate of 48 states of the US (excluding California and Texas) at 23.8% to a remarkably high 35.8%. [2]

Texas 2011-2012 Maternal Death Cohorts - Six Most Prevalent Causes of Death by Race-Ethnicity Texas 2011-2012 Maternal Death Cohorts - Six Most Prevalent Causes of Death by Race-Ethnicity.png
Texas 2011-2012 Maternal Death Cohorts - Six Most Prevalent Causes of Death by Race-Ethnicity
Texas 2017 report on leading causes of death among infants by Race-Ethnicity, Healthy Texas Babies Initiative Leading Causes of Death by Race-Ethnicity, Healthy Texas Babies Initiative Oct 2017.png
Texas 2017 report on leading causes of death among infants by Race-Ethnicity, Healthy Texas Babies Initiative

In the United States the maternal mortality ratio rose during the years 2002-2015. [3] Although improvements in health care facilitated a dramatic decline in maternal mortality worldwide during the 20th century, women still die from complications of pregnancy, though there are significant differences in the top causes per region and income class. [3] Since 1990 the World Health Organization measures both the maternal mortality ratio and the maternal mortality rate. In 1994 the period of measurement for a "maternal-related death" after childbirth was extended from six weeks to a year after the "birth event". The United States is one of the few developed countries for which both of the WHO measurements have gone up and not down. Nationally as well as in Texas, black women have a maternal mortality rate more than twice as high as White women and this disparity gap has increased since 2007, but the causes of this increase were unclear in 2013 and therefore the task force was formed to investigate. [1] The estimated maternal mortality rate (per 100,000 live births) for 48 states and Washington, DC (excluding California and Texas) increased by 26.6%, from 18.8 in 2000 to 23.8 in 2014. [4] California showed a declining trend, whereas Texas had a sudden increase in 2011-2012. [4] The Texas rate had nearly doubled. [5] Although reproductive health and maternal death is significantly different for black women, this is not part of the study conducted by the Boston Black Women's Health Study and the taskforce is the only known body studying this aspect. Since convening in 2013 the task force has produced two reports, in July 2014 and in September 2016.

In the latest report it shows a significantly higher increase in maternal mortality for black women. This may be related to a higher incidence of pre-pregnancy obesity, which has both been shown to be higher in black women[ citation needed ] and to be correlated to a first-time cesarean section. [6] It may also be related to discrimination in health care for black women, which can take the form of reduced access to services and information. [7]

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Infant mortality Death of children under the age of 1

Infant mortality is the death of young children under the age of 1. This death toll is measured by the infant mortality rate (IMR), which is the probability of deaths of children under one year of age per 1000 live births. The under-five mortality rate, which is referred to as the child mortality rate, is also an important statistic, considering the infant mortality rate focuses only on children under one year of age.

The maternal mortality ratio is a key performance indicator (KPI) for efforts to improve the health and safety of mothers before, during, and after childbirth per country worldwide. Often referred to as MMR, it is the annual number of female deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management. It is not to be confused with the maternal mortality rate, which is the number of maternal deaths in a given period per 100,000 women of reproductive age during the same time period. The statistics are gathered by WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. The yearly report started in 1990 and is called Trends in Maternal Mortality. As of the 2015 data published in 2016, the countries that have seen an increase in the maternal mortality ratio since 1990 are the Bahamas, Georgia, Guyana, Jamaica, Dem. People’s Rep. Korea, Serbia, South Africa, St. Lucia, Suriname, Tonga, United States, Venezuela, RB Zimbabwe. But according to Sustainable Development Goals report 2018, the overall maternal mortality ratio has declined by 37 percent since 2002. Nearly 303,000 women died due to complications during pregnancy.

Maternal death Aspect of human reproduction and medicine

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A maternal near miss (MNM) is an event in which a pregnant woman comes close to maternal death, but does not die – a "near-miss". Traditionally, the analysis of maternal deaths has been the criterion of choice for evaluating women's health and the quality of obstetric care. Due to the success of modern medicine such deaths have become very rare in developed countries, which has led to an increased interest in analyzing so-called "near miss" events.

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Maternal health in Uganda

Like many developing countries, Uganda has high maternal mortality ratio at 343 per 100,000 live births. According to the World Health Organization (WHO), a maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. In situations where attribution of the cause of death is inadequate, another definition, pregnancy-related death was coined by the US Centers for Disease Control (CDC), defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death.

Womens health in India Demographic health topic

Women's health in India can be examined in terms of multiple indicators, which vary by geography, socioeconomic standing and culture. To adequately improve the health of women in India multiple dimensions of wellbeing must be analysed in relation to global health averages and also in comparison to men in India. Health is an important factor that contributes to human wellbeing and economic growth.

This article summarizes healthcare in Texas. In 2017, the United Healthcare Foundation ranked Texas as the 34th healthiest state in the United States. Obesity, excessive drinking, maternal mortality, infant mortality, and vaccinations are among the major public health issues facing Texas.

Maternal healthcare in Texas

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Maternal mortality in the United States Overview of maternal mortality in the United States

Maternal mortality refers to the death of a woman during their pregnancy or up to a year after their pregnancy has terminated; this only includes causes related to their pregnancy and does not include accidental causes. Some sources will define maternal mortality as the death of a woman up to 42 days after their pregnancy has ended, instead of one year. In 1986, the CDC began tracking pregnancy related deaths to gather information and determine what was causing these deaths by creating the Pregnancy-Related Mortality Surveillance System. Although the United States was spending more on healthcare than any other country in the world, more than two women died during childbirth every day, making maternal mortality in the United States the highest when compared to 49 other countries in the developed world. The CDC reported an increase in the maternal mortality ratio in the United States from 18.8 deaths per 100,000 births to 23.8 deaths per 100,000 births between 2000 and 2014, a 26.6% increase. As of 2018, the US had an estimated 17.4 deaths per 100,000 live births. It is estimated that 20-50% of these deaths are due to preventable causes, such as: hemorrhage, severe high blood pressure, and infection.

The weathering hypothesis was proposed to account for early health deterioration as a result of cumulative exposure to experiences of social, economic and political adversity. It is well documented that minority groups and marginalized communities suffer from poorer health outcomes. This may be due to a multitude of stressors including prejudice, social alienation, institutional bias, political oppression, economic exclusion and racial discrimination. The weathering hypothesis proposes that the cumulative burden of these stressors as individuals age is "weathering," and the increased weathering experienced by minority groups compared to others can account for differences in health outcomes. In recent years, the biological plausibility of the weathering hypothesis has been investigated in studies evaluating the physiological effects of social, environmental and political stressors among marginalized communities. This has led to more widespread use of the weathering hypothesis as a framework for explaining health disparities on the basis of differential exposure to racially based stressors. Researchers have also identified patterns connecting weathering to biological phenomena associated with stress and aging, such as allostatic load, epigenetics, and telomere shortening.

Maternal mortality in India Overview of maternal mortality in India

Maternal mortality in India is the maternal death of a woman in India during pregnancy or after pregnancy, including post-abortion or post-birth periods. Different countries and cultures have different rates and causes for maternal death. Within India, there is a marked variation in healthcare access between regions and in socioeconomic factors, accordingly, there is also variation in maternal deaths for various states, regions, and demographics of women.

The World Health Organization (WHO) defines maternal mortality as death that occurs during pregnancy, birth and up to 42 days postpartum. Black maternal mortality in the United States refers to the incidence of maternal mortality in the U.S. specifically for those identifying as black or African American. The usual causes of maternal mortality are conditions that occur or are exacerbated during pregnancy. Therefore, most instances of maternal mortality are preventable deaths. In the U.S., the CDC reported that black women experience maternal mortality at a rate two to three times higher than that of white women. Researchers have identified several reasons for the black–white maternal mortality disparity in the U.S., including historical reasons, access to care, socioeconomic status, incidence of preexisting conditions, medical racism, and abortion access all of which are social determinants of health in the United States.

Maternal health outcomes differ significantly between racial groups within the United States. The American College of Obstetricians and Gynecologists describes these disparities in obstetric outcomes as "prevalent and persistent." Black, indigenous, and people of color are disproportionately affected by many of the maternal health outcomes listed as national objectives in the U.S. Department of Health and Human Services's national health objectives program, Healthy People 2030. The American Public Health Association considers maternal mortality to be a human rights issue, also noting the disparate rates of Black maternal death. Race affects maternal health throughout the pregnancy continuum, beginning prior to conception and continuing through pregnancy (antepartum), during labor and childbirth (intrapartum), and after birth (postpartum).

References

  1. 1 2 Maternal Mortality and Morbidity Task Force on Department of State Heath Services website
  2. Texas has highest maternal mortality rate in developed world, study finds, 20 August 2016 article in the Guardian
  3. 1 2 Maternal mortality ratio (modeled estimate, per 100,000 live births) on website of The World Bank
  4. 1 2 MacDorman, MF; Declercq, E; Cabral, H; Morton, C (2016). "Recent Increases in the U.S. Maternal Mortality Rate: Disentangling Trends From Measurement Issues". Obstet Gynecol. 128 (3): 447–55. doi:10.1097/AOG.0000000000001556. PMC   5001799 . PMID   27500333.
  5. Maternal Mortality Rate in U.S. Rises, Defying Global Trend, Study Finds in New York Times, 21 September 2016
  6. Birth by the Numbers from the Boston University School of Public Health
  7. Reproductive Injustice: Racial and Gender Discrimination in U.S. Health Care by the Center for Reproductive Rights and the National Latina Institute for Reproductive Health