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MATERNAL
MORTALITY

percent were preventable and 3.2 percent TABLE 1
were undetermined. 68.2 percent of cardio-
vascular conditions and 70 percent of hem-
orrhages were preventable. Distribution of
contributing factors among pregnancy related
deaths shows 38.2 percent were patient and
family related and 33.9 percent were provider
related (Figure 3) slide 27 from John Duah.
CDC also found that there will be a giant im-
pact when social determinants of health are
addressed.
A report published in the September issue
of the journal Obstetrics & Gynecology
found that from 2000 to 2014, the maternal
mortality rate for 48 states in the U.S. and
Washington, D.C. increased 27 percent from
close to 19 deaths per 100,000 live births to
close to 24 deaths per 100,000 live births.
This one publication has generated an ava-
lanche of activities particularly in Texas that
was shown to have the highest MMR in the
FIGURE 1
country. Nationally and in Texas the number
of African-American mothers dying is three
times as high as white mothers. African-
American mothers in Texas are dying at the
highest rates of all.
A 2016 joint report by the Texas Depart-
ment of State Health Services’ Maternal
Mortality and Morbidity Task Force found
that black mothers accounted for 11.4 per-
cent of Texas births in 2011 and 2012, but
28.8 percent of pregnancy-related deaths.
Bexar County is carrying its own burden
as well. (Table 2.) As per the statistics from
the Texas department of state health services
who publish health, stats there were 11 ma-
ternal deaths in Bexar County in 2016. Noth-
ing more than this number can be obtained
as the medical records are HIPPA protected.
Metro Health Department has setup a task- Often Hispanic mothers are neglected, invoking the ‘Hispanic Paradox’ which states that
force to review maternal mortality in Bexar infant mortality and maternal mortality in the Hispanic and Latino populations is com-
County. Work of the taskforce is impeded by parable to non-Hispanic whites.
lack of access to the mother’s medical Irrespective of all considerations, one maternal death is one too many regardless of
records. The cause of death, circumstances who dies and where she died. It is clearly shown in the CDC analysis that the largest im-
of death, location, outcome of the infant are pact will be to address the social determinants of health. It takes a village to raise a child.
all questions that have no answers. We have Nurturing the mother to be and the new mother is everyone’s concern.
no idea about the ethnicity of these mothers. In the Premiere clinic I performed my duties mechanically. I knew one of the baby

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