The United States has the worst maternal mortality rate in the developed world.
If legislation to create a Maternal Mortality Review Committee is signed into law in early May, Nevada would join 44 other states that are eligible for federal grant money to collect data and take other steps to reduce pregnancy-related deaths.
States have until May 8 to apply for grants from the Centers for Disease Control and Prevention to be awarded to state Maternal Mortality Review Committees. But those committees, or legislation to create those committees, have to already be established. “The timing is good, we just need to move expeditiously,” said Catherine O’Mara, the executive director of the Nevada State Medical Association.
Assembly Bill 169, which was passed out of the Assembly unanimously April 16, was voted out of the Senate Health and Human Services Committee during its first hearing April 24. Democratic Assemblywoman Daniele Monroe-Moreno said the bill could be read on the Senate floor as early as Monday.
The legislation would create the first statewide effort to examine Nevada mortality and morbidity rates among pregnant women, and try to figure out how to respond.
“The United States is the only high-resourced country with a high mortality rate,” she said. “An estimated 700 women die each year from pregnancy-related deaths. Another 65,000 have health complications during and after their pregnancies.”
The disparities are worse for black women. According to the CDC, every year 40 black women, per 100,000 births, die because of pregnancy-related deaths compared to 12 white women.
Reasons for deaths vary, but the CDC notes some of the top reasons include cardiovascular disease, infection or sepsis and hemorrhaging — health experts add many of these deaths are preventable.
Nevada’s overall rate for maternal mortality is 6.2 deaths per 100,000 according to America’s Health Rankings. Even though Nevada’s rate is lower than the national average, O’Mara said the state still needs data.
The Nevada State Medical Association, she added, tried to undertake a review on its own, but ultimately decided it would be more effective to rope in the state.
The bill would establish a six-to-12-member Maternal Mortality Review Committee within the Nevada Department of Health and Human Services — members include health care providers, public health officials, law enforcement and those from nonprofits who work with women’s issues. “The committee is responsible for reviewing incidents of mortality when a woman is pregnant and within one year of birth,” said O’Mara.
The review would also come with a plan on how to reduce rates and recommend legislation that could change state policies. “It would make specific, data-driven recommendations to improve the health of women in Nevada,” O’Mara said.
Monroe-Moreno said she’s heard from constituents requesting the state to more actively protect and promote the health of pregnant women. One woman she heard about kept telling her doctor something felt wrong about the pregnancy. The doctor didn’t take her concerns seriously. “It turns out she had a rare genetic disorder,” she said.
The woman almost died multiple times and had to be resuscitated at one point.
With celebrities like Beyoncé and Serena Williams discussing their difficult pregnancies, the issue of women — in particular women of color — having their health and pregnancy concerns ignored by doctors has been getting more attention. “If (a doctor) is not going to listen to Serena Williams, they aren’t going to listen to a woman from West Las Vegas,” Monroe-Moreno added.
It’s not just states that are responding to the health issue. In December 2018, the federal Preventing Maternal Deaths Act of 2017 was signed into law and amended the CDC’s Safe Motherhood and Infant Health Initiative.
The CDC is expected to allocated $43 million in grant funding for state and local governments that create committees to track pregnancy-related deaths. The Nevada State Medical Association is hoping to capitalize on the funding.
Few presidential candidates have discussed mortality rates among pregnant women, but that’s beginning to change.
Before hitting the campaign trail, U.S. Sen Kamala Harris introduced the Maternal Care Access and Reducing Emergencies Act in August to reduce racial disparities in maternal mortality and morbidity.
The bill would create grant funding to implement implicit bias training in medical and nursing programs and offer incentives to providers who offer integrated health care services that are specifically designed to reduce maternal deaths and racial health disparities.
Last summer, Monroe-Moreno said Harris reached out to her to discuss the potential legislation in Nevada and to see if she needed resources in moving forward on the legislation.
On the same day Monroe-Moreno was presenting AB169, U.S. Sen. Elizabeth Warren, speaking at the She The People presidential forum, was also making the case on how to fix maternal mortality rates. “The mistreatment of Black and Brown women around maternal health is the direct result of institutional and structural racism,” she later said on Twitter.
Her solution: “Hit health care providers in their wallets.” If health care providers are able to reduce mortality rates, they will get financial incentives. If they don’t reduce deaths, they will lose funding.
Monroe-Moreno said it was a good sign that more candidates are starting to talk about maternal morality rates. “With more women coming to the table, the conversation is changing and we are starting to discuss issues that weren’t being discussed,” she added. “It gives me hope.”