D.C. Council Mulls Maternal Mortality Review Committee

The D.C. Council recently moved to address the staggering increase in District women dying during pregnancy, labor or within weeks of delivery by establishing the D.C. Maternal Mortality Review Committee.

According to a bill introduced by Council member Charles Allen, D.C.’s maternal mortality rate was gauged at 39 deaths per 100,000, surpassing states such as New Jersey, Maryland and Virginia.

“Maternal mortality rates in the District indicate nothing short of a maternal health crisis,” Allen said in a statement. “The District’s maternal mortality rate is far higher than in neighboring jurisdictions and the United States as a whole. And we don’t have consistent data to tell us why.”

The death rates vary by race, with African-American women three times as likely to die of pregnancy-related causes than other ethnicities — largely due to chronic health conditions that go untreated or during pregnancy, including hypertension, diabetes and heart disease.

Shana Bartley, acting executive director for the organization D.C. Action for Children, offered testimony during a public hearing for the legislation B22-0522 — The Maternal Mortality Review Committee Establishment Act of 2017, that streamlining maternal health care is essential to overall family health.

“The link between maternal and child outcomes cannot be overstated,” Bartley said. “During pregnancy, chronic maternal conditions such as obesity, diabetes, hypertension as well as parental environmental exposure and psychological stressors have an impact on fetal and infant health.

“Not only does maternal health during pregnancy affect child health, but maternal presence also supports positive child outcomes after birth,” she said. “Therefore, protecting the lives of pregnant women and mothers is incumbent upon the District, both for the sake of the mother and of her child.”

Bartley testified that recent changes to D.C.’s maternal and child health care system have the potential to affect the District’s already-high maternal and infant mortality rates and emphasize the need for close attention to maternal health outcomes.

“In the past year, two of D.C.’s seven hospital maternity wards closed, accompanying a shift in Medicaid managed care organizations that has altered the landscape and affected some women’s ability to receive care from their preferred providers,” Bartley said. “In response, other hospitals are building capacity to take on more patients as well as form new partnerships with community-based providers.

“Given already-high maternal and infant mortality rates in D.C., we are concerned about the cumulative impacts of these changes on maternal mortality in the District, especially amongst those pregnant women at greatest risk for negative birth outcomes, including maternal death,” she said. “We believe that a maternal mortality review board, alongside preemptive strategies, is essential to monitoring the effects of these changes and sharing findings that may prevent future deaths.”

If the D.C. bill passes a second vote and is approved by Mayor Muriel Bowser, the committee would function under the chief medical examiner, whose office would conduct and publish research and policy guidelines.

“If we want to put the right policies and priorities in place to prevent more deaths related to childbirth, we need to understand what’s happening to our mothers,” Allen said. “Getting a maternal mortality review committee up and running is the first step to charting a path forward and saving women’s lives.”

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