RICHMOND, Va. — Hundreds attended a summit in Richmond on Monday aimed at eliminating infant and maternal deaths in Virginia.
The summit was hosted by the Virginia Neonatal Perinatal Collaborative (VNPC), which states it “exists to ensure that every mother has the best possible perinatal care, and that every infant cared for in Virginia has the best possible start to life.”
“The great part about a summit like this is you get to engage with providers at all levels from the OBs to maternal medicine to doulas, community workers, you have all people coming to the table to really discuss the issue of perinatal and maternal mortality,” said Dr. Melanie Rouse, Projects Manager of the Virginia Maternal Mortality Review Team (a state group tasked with analyzing the issue).
The issue of maternal mortality, which is the death of a mother within a year of the end pregnancy (regardless of the pregnancy’s outcome or cause of death) is one where the United States is heading in the wrong direction. The Virginia Maternal Mortality Review Team (VMMRT) said that according to the World Health Organization, “maternal mortality declined more than 40% worldwide between 1990 and 2014. However during the same time period, there was an approximately 26% increase in maternal mortality rates in the United States.”
“From the national level, we’re not doing as well as we should be doing. It’s been increasing over the last few years and we’ve noticed, kind of, the similar trend in the state, which is why we put a lot of focus on addressing the maternal mortality issue,” said Rouse. “We have overall rate of about 35.7 [per 100,000 in Virginia]. When we break it down by race. African-American women are two-to-three times at risk, two-to-three times higher than for white women.”
Rouse said a lot of the underlying causes for the racial disparities in the mortality rate are the same as what is seen for “health disparities in general.”
“There’s also been the issues of implicit bias and health equity issues that also heavily influence and impact maternal mortality and the disparities,” said Rouse. “Perhaps a woman will present and a provider may make assumptions based on her social history and that may make a difference in how they’re treated. You know, it’s an unconscious bias. Not something you necessarily think about, but it may make a difference in how you treat people and take their concerns.”
Rouse said when it comes to addressing the racial disparity factor, just talking about it is a start.
“Really actually being open and discussing the issue and working with providers to have implicit bias training,” added Rouse.
At the conference, attendees also heard from those whose lives have been impacted by the issue of maternal mortality.
Crystal Matthews told her story about her sister, Carrie Naas, who died at the age of 39.
“She was a wonderful soul. Taken from the earth, obviously, too soon,” said Matthews. “Uncomplicated pregnancy other than advanced maternal age.”
Matthews said Naas was in the hospital preparing to give birth when something went wrong.
“She’s putting on mascara from her bed, anticipating the guests and the delivery of Noah [her son]. And then all of a sudden she’s just not feeling right, the impending doom. Couldn’t explain it and the family was asked to leave the room and she passed while we were in the waiting area,” said Matthews. “Noah was delivered without a heartbeat. He was resuscitated and is doing great three-and-a-half years later.”
Matthews said Naas died from an amniotic fluid embolism (AFE)) and which she added was unpreventable, unpredictable, and rare event in pregnancy.
“There’s just a lot of awareness and education that needs to happen. AFE is rare and not many people hear about it. So, even today, even at this conference with over 400 people when I talk about it, people say what was that? I’ve never heard of that before,” added Matthews. “My goal and my hope is that this is just education. Get familiar with the things that are still rare. And hope that research will later tell us, in hopefully a year, probably not, but in many years to come, that it could be preventable.”
In December 2019, Governor Ralph Northam, who said he wants to eliminate the racial disparity by 2025, unveiled that in his two-year budget proposal was $22-million for programs aimed at lowering the infant and maternal mortality rates and racial disparity in Virginia, including extending FAMIS MOMs' Medicaid coverage program from 60-days post birth to one full year and making home visiting services eligible for Medicaid reimbursement.
A spokesperson for Northam said that while the House and Senate versions of the budget passed last week move some of the money around in terms of which year it is slated for, the $22-million remains.