The medical community has benefited tremendously from the phenomenal advances in clinical care and groundbreaking treatments that have emerged from scientific research. But in many instances, these breakthroughs have not improved our ability to provide the life-saving care that patients expect and deserve. It’s clear that we have a significant discovery-to-care delivery gap in this country. Nowhere is that disparity more glaring than when it comes to caring for some of the most vulnerable in our communities, particularly pregnant women of color.
Maternal mortality remains a health crisis in the U.S., where in 2021 the maternal mortality rate was 32.9 deaths per 100,000 live births, according to Centers for Disease Control and Prevention data released this year. That’s up from 23.8 in 2020 and 20.1 in 2019. Pregnant women in the U.S. have the highest maternal mortality rates among high-income countries and are more than 10 times more likely to die compared with estimated rates in some of those nations. For Non-Hispanic Black pregnant women, the mortality rate is three to four times higher than for white or Hispanic pregnant women. All of these trends are difficult to comprehend.
While the numbers are alarming, research from the Milken Institute published in August found that 84% of pregnancy-related deaths were considered to be preventable. But reducing maternal mortality is not about a lack of scientific research or developing innovative new treatments. It comes down to providing access to comprehensive personalized care and understanding the unique needs of patients, so that millions of women aren’t left wondering if a pregnancy could mean their life is at risk.
The situation is only getting worse. The Journal of the American Medical Association found in July of this year that U.S. maternal deaths nearly doubled from 2018 to 2021, making it imperative we treat this like the preventable health crisis it is.
That is why Westchester Medical Center Health Network (WMCHealth) in June launched the Center for Women’s Health Equity, the first-of-its-kind care program in New York’s Hudson Valley designed to address the social, economic, cultural and racial determinants of health that can result in increased maternal morbidity and mortality.
As director of the Department of Obstetrics and Gynecology at Westchester Medical Center, a major safety-net academic medical center a few miles from the Bronx, I witness the dire consequences of unaddressed gaps in care every day. But maternal health challenges spare no one and transcend socio-economic determinants, as evidenced by the death of Olympic gold medalist Tori Bowie earlier this year due to complications from childbirth.
Our mission is to address the social factors that contribute to these astonishing disparities, leading us to establish the center on five pillars: integration of clinical care, education and development of doctors in training, population-based research, government advocacy and community partnerships.
We are connecting high-risk pregnancy specialists in maternal fetal medicine with cardiovascular experts to address heart disease and hypertension, among the leading causes of maternal morbidity and mortality. We are also employing multilingual social workers to tackle mental health and addiction disorders, which are other leading causes of morbidity and mortality.
With maternal health, most deaths occur after a patient has left the hospital. The reasons vary, such as lack of access to postpartum care, failure to identify postpartum complications or challenges with mental health. To bridge these care gaps, we have extended our postpartum care period from six months to one year and even beyond. We are also partnering with local doulas and working with multilingual care providers and domestic violence care shelters.
Our hope is that this program becomes a model for other healthcare systems, demonstrating how a comprehensive approach with strong community partnerships can help put an end to this deadly cycle.
It’s a privilege for healthcare organizations when pregnant patients and their families place such tremendous trust in their care teams. It’s our responsibility to make sure that welcoming a newborn child is always the best day of their lives.