Local health care professionals and advocates are working to advance women’s health services in the Conroe and Montgomery areas as Texas’ rate of maternal mortality has garnered national and statewide attention in recent months for its seemingly high numbers. Maternal mortality is defined by the World Health Organization as when a mother dies from pregnancy-related complications while pregnant or within 42 days of giving birth. Texas’ maternal mortality rate increased from 10.1 deaths per 100,000 births in 2005 to 38.7 deaths in 2012 before declining slightly to 32.5 deaths in 2015, according to an October 2017 report from Texas Health and Human Services. Over the same period, the U.S. maternal mortality rate increased from 15.1 deaths per 100,000 births in 2010 to 20.9 deaths in 2015. Although a 2016 study reported the maternal mortality rate in Texas nearly doubled from 2010-12, many health experts credit the rapid increase to overreporting and incomplete data. Chris Van Deusen, director of media relations for the Texas Department of State Health Services, said via email that maternal deaths in Texas are relatively rare and department researchers determined the 2010-12 report was incorrect due to inconsistent reporting. “Maternal mortality remains an issue that we’re dedicated to addressing,” Van Deusen said. “We’re not suggesting there hasn’t been a gradual increase in Texas, as there has been nationally, but there’s no evidence to support that big ‘spike’ that was previously reported.” While experts debate the merit of the data, local entities are conducting their own research and implementing changes on a local level. The Houston Endowment Maternal Mortality Steering Committee published a report in April 2018 outlining nine solutions to improve maternal health, including improving data collection and analysis of women’s health, addressing implicit bias and increasing access to primary health care and providers that accept Medicaid. Hospital Corporation of America’s Gulf Coast Division—which owns Conroe Regional Medical Center and 13 other area hospitals that deliver babies—reported zero maternal deaths since 2017, said Holly Elliot, HCA Gulf Coast Division vice president of women’s services. HCA Gulf Coast administrators and physician experts worked with the committee to investigate maternal mortality, and the division will adopt the recommendations made in the April report, Elliot said. “We will work with our physicians in each of our markets to ensure that we are focusing on the prevention of maternal death,” she said.

Identifying factors, solutions

Andie Wyrick, a certified nurse midwife and co-founder of Holistic Heritage Homebirth in Montgomery, offers midwifery services to women, including those who have low-risk pregnancies. Midwives are trained medical professionals who promote natural births. Wyrick said mothers are often left to their own devices postpartum in the traditional medical system, and checkups with an obstetrician are often limited to a single encounter six weeks after delivery. “Moms are kind of thrown out there to the wolves, and then they’re not seen again after they leave the hospital until two weeks later—if the physician is good,” she said. “And if it’s a traditional system, [mothers are not seen again] until their six-week appointment. … It’s not fair. It’s a broken system, and we can do better.” However, this system may be changing. In May, the American College of Obstetricians and Gynecologists Committee published a revision to their postpartum care system, recommending women have contact with their obstetrician within the first three weeks following birth and that subsequent postpartum care be an ongoing process. Additionally, Van Deusen said the DSHS recently launched the TexasAIM program, which is an effort to help hospitals use evidence-based practices to prevent and respond to pregnancy complications. As of May 31, more than 160 Texas hospitals have enrolled in the program, including CHI St. Luke’s Health The Woodlands Hospital, Memorial Hermann The Woodlands Medical Center and Houston Methodist Childbirth Center at The Woodlands. “We’ve had a tremendous response from hospitals already,” Van Deusen said. “Similar efforts have been very successful in some other states ... and we’re hopeful it can make a difference in Texas.”