Missouri faces a grim statistic. Right now, the Show Me State ranks 44th out of all states in maternal mortality according to calculations by the Missouri Foundation for Health. The rankings are an important metric for health experts and professionals.
Maternal mortality is often used as an indicator of the quality of the health care system in any state or country. Maternal mortality is defined by a death that occurs while a woman is pregnant, or within one year after the end of her pregnancy. Causes of maternal mortality are epistemic; factoring in social, nutritional, medical, and many other factors that may contribute to a mother’s cause of death. The multi-faceted nature of maternal mortality makes the statistic a good proxy for determining the overall quality of Missouri Healthcare.
This summer, the Missouri Department of Health and Senior Services (DHSS) issued its latest report on Missouri maternal mortality. Doctors and statisticians compiled the results of all Missouri pregnancies in 2017 for this year’s report. Missouri DHSS found 68% of maternal deaths were not related to the pregnancy for a mortality ratio of 56 maternal deaths per 100,000 live births. Maternal deaths related to complications of pregnancy accounted for 32% of maternal deaths and a mortality ratio of 26 maternal deaths per 100,000 live births.
Epidemiologists categorize maternal mortality in two ways. Pregnancy-associated deaths are defined as a cause of death unrelated to pregnancy within one year of giving birth. Pregnancy-related deaths are defined as a cause of death related to pregnancy or a cause of death due to a medical condition aggravated by pregnancy within one year of giving birth.
In Missouri’s Black community, the pregnancy-associated death rate was four times greater than in Missouri’s white community in 2017. The leading cause of pregnancy-associated death was injuries and motor vehicle crashes (41%), followed by overdoses/poisonings (33%)in 2017. Mental health contributed to 27% of pregnancy-associated and 16% of pregnancy-related deaths in 2017. Economics may be a contributing factor to maternal mortality. The rate of pregnancy-associated deaths for women on Medicaid was more than 5 times greater than the rate for those with private insurance in 2017.
Cardiomyopathy is a condition that makes it difficult for the heart to pump blood to the rest of the body. Cardiomyopathy was the leading underlying cause of pregnancy-related deaths (26%) in 2017. Eighty percent of pregnancy-related deaths are thought to be preventable by Missouri DHSS.
Black babies in Missouri are also more likely to be born premature, 17.8 premature births per 100 births for black Missourians compared to 11.2 premature births per 100 for white Missourians. As a result of these statistics, it’s no surprise the rate of infant death in the Missouri Black community is more than twice as high as in the white community, 15 deaths per 100 births versus 6.2 deaths per 100 births for white Missourians.