Maternal Deaths: Illinois Studies Pregnancy-Related Deaths

ILLINOIS — The Illinois Department of Public Health last week released its first Maternal Morbidity and Mortality Report, revealing an alarming trend among new mothers in Illinois. According to the study, which is a joint effort of two IDPH committees, each year in Illinois an average of 73 women die within one year of pregnancy. The study also found that black women are six times more likely to die of a pregnancy-related condition than white women, and that 73 percent of pregnancy-related deaths and 93 percent of violent pregnancy-related deaths are preventable.

According to the report, which provides recommendations to prevent maternal deaths, obesity also contributed to 44 percent of pregnancy-related deaths in Illinois in 2015.

Released earlier this year, a four-year USA Today investigation found that the United States is the "most dangerous place to give birth in the developed world," with 50,000 mothers becoming severely injured during or after childbirth, and 700 dying. Between 1990 and 2015, while the number of maternal deaths dropped worldwide, it rose sharply in the United States, the study found.

Out of 47 states ranked as part of the USA Today study, Illinois ranked 18th in maternal deaths, with a death rate of 14.7 per 100,000 births between 2012 and 2016.

Related: Suburban Mom Dies After Giving Birth To Twins

"The Illinois panel that reviews mothers’ deaths, created in 1982, published a study in 2014 that deemed 1 in 3 maternal deaths in Illinois were preventable," USA Today found. "The team's findings led Illinois to launch a program designed to get the state's hospitals to adopt a curriculum teaching doctors, nurses and other medical staff how to better deal with hemorrhage."

IDPH's Maternal Morbidity and Mortality Report is the result of more than a year of work done by the Maternal Mortality Review Committee (MMRC), established in 2000, and the Maternal Mortality Review Committee for Violent Deaths (MMRC-V), established in 2015. The committees analyzed the 93 pregnancy-related maternal deaths that occurred in 2015.

As part of the report, the committees made specific recommendations expected to reduce maternal deaths. The recommendations focus on five primary categories: hospitals, health care providers, health insurance plans and managed care organizations, the State of Illinois, and women and their families.

Key recommendations from the report:

• Illinois should expand Medicaid eligibility for the postpartum period from 60 days to one year after delivery and health insurance plans should cover case management and outreach for high-risk postpartum women for up to one year after delivery.
• The General Assembly should pass legislation to adopt the American College of Obstetricians and Gynecologists’ recommended maternal levels of care within the state’s regional perinatal system.
• The State should create or expand home visiting programs to target high-risk mothers, such as doula programs, in Illinois during pregnancy and the postpartum period. The State should also expand efforts to provide universal home visiting to all mothers within three weeks of giving birth.
• Illinois should increase access to substance use and mental health services statewide for pregnant and postpartum women.
• Hospitals should have clear policies for emergency departments to identify pregnant and postpartum women, and to consult with an obstetrical provider for all women with specific triggers indicative of pregnancy or postpartum complications.
• Health insurance plans should separate payment for visits in the postpartum period from labor and delivery (unbundle postpartum visit services from labor and delivery).

"IDPH remains committed to identifying and reviewing maternal deaths and morbidities and will build upon these findings and recommendations over the coming years," IDPH said on the report, and committees have begun reviewing 2016 maternal deaths. IDPH said the State of Illinois is also taking steps to reduce the number of pregnancy-related deaths including:

• Improving quality in maternal and neonatal outcomes in collaboration with the Illinois Perinatal Quality Collaborative (ILPQC). In 2016, IDPH doubled the funding for ILPQC compared to the previous year. IDPH continues to fund ILPQC to improve outcomes for women with severe hypertension and opioid use disorder, two leading causes of maternal mortality in Illinois. This effort has resulted in a significant increase in the number of women who:
  • received treatment for severe hypertension within 60 minutes
  • scheduled follow-up appointments before leaving the hospital
  • went home with information on preeclampsia and understanding symptoms of postpartum
• Work is currently underway with the majority of birthing hospitals to improve outcomes for pregnant women with opioid use disorder.
• Collaborating with the University of Illinois at Chicago in 2016 to be the first state in the country to review severe maternal morbidity, which can inform what successful strategies can be used to prevent women from dying.
• Partnering with Administrative Perinatal Centers to deliver obstetrical hemorrhage education to ensure that all new obstetric staff members are educated on obstetrical hemorrhage protocols within their first year of service. The training was updated in 2016 hospital retraining is ongoing.

“By studying maternal mortality and morbidity (pregnancy complications), we can identify some of the most common complications pregnant and postpartum women face and understand what is causing them,” said IDPH Director Nirav D. Shah. “Equipped with that information, we can address those causes head on, take action to reverse poor health outcomes, and improve the health of women and their babies.”

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