The World Health Organization defines maternal mortality as a mother’s death 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 per 100,000 births in 2012 before declining slightly to 32.5 deaths per 100,000 births 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 credited the rapid increase to overreporting and incomplete data. In fact, the U.S. has not published an official national mortality rate since 2007.
“That spike [between 2010 to 2012 in Texas] is not an accurate reflection,” said Ashley Klemm, a Tomball certified labor doula who supports mothers throughout pregnancy. “[Texas] did not just go from bad to really, super bad. There is still an increasing trend.”
An April 2018 study from the Houston Endowment’s Maternal Mortality Steering Committee found the Tomball and Magnolia areas do not have a higher risk of maternal mortality than Texas and Harris County. However, committee member Kay Matthews said rural areas with smaller hospitals and fewer resources or areas that lack a hospital altogether are more at risk.
“It makes a difference when women do not have immediate access to care like [they] would have in a major city,” Matthews said. “It does make it difficult. All women need to have access to care or mental support.”
Local Support of women’s health
Hospital Corporation of America’s Gulf Coast Division—which owns Tomball Regional Medical Center and 13 other hospitals in the region that deliver babies—reported zero maternal deaths since 2017, said Holly Elliot, HCA Gulf Coast Division vice president of women’s services.
“[Maternal mortality] is still a concern for us,” Elliot said. “This is an indicator that we look at each month as a part of our quality care scorecard.”
Elliot said HCA plans to continue recruiting, investing and expanding services available at the Women’s Center, the gynecological care arm of TRMC, and to the Greater Tomball and Magnolia areas. Since being acquired by HCA Gulf Coast last July, TRMC has doubled its OB-GYNs from three to six.
“I will work with the local team at Tomball Regional as well as with the high-quality physicians in that market to continue to expand services and make sure we are providing comprehensive women’s services to moms and babies in the Tomball and Magnolia area,” Elliot said.
HCA Gulf Coast assigned a number of administration and physician experts to work with the Maternal Mortality Steering Committee, which outlined nine solutions in April 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 Medicaid-accepting providers.
Identifying factors, solutions
Markisha Mitchell, a registered nurse and community relations professional at Medella Urgent Care in Magnolia, said key reasons for higher pregnancy-related deaths include poor access to health care, a health care provider shortage, discrimination and lack of information about family planning.
“We are not exactly sure why a country that touts itself as having the best health care system has this problem,” she said.
Matthews, who launched the Shade of Blue Project to provide a community for women of color to discuss their pregnancy concerns and find resources, said women can take a more active role in their postpartum care.
“Having a child doesn’t start and end with giving birth; there has to be even more care after the delivery,” she said. “We need to talk about [maternal mortality and morbidity] more. There is not enough conversation in our communities. It is holding us back.”