As a Houston, Texas medical malpractice attorney, I was interested and saddened to read about a dramatic 87% increase in the Texas maternal mortality rate in the five-year period of 2011-2015 (the most recent data available).
The maternal mortality rate refers to the rate at which mothers die in the labor and delivery process of babies. Medical experts use this information to assess patient safety.
For the time period of 2006-2010, the overall maternal mortality rate was 18.3 deaths of mothers per 100,000 live baby births. For the next available time period, 2011-2015, there was an 87% increase of the overall maternal mortality rate, up to 34.2 deaths of mothers per 100,000 live baby births.
While the overall increases are disturbing, the rates for certain races are even worse. African-American women in Texas had a maternal mortality rate of 85.6 deaths of mothers per hundred thousand live baby births, which is more than double that of non-Hispanic white women.
Causes of birth-related deaths of mothers
Many maternal health experts believe that there are five main causes of birth -related deaths of mothers in the United States.
Embolism is the first major cause of maternal death, accounting for 20% of maternal deaths. Embolism refers to a blood clot that forms, breaks loose, and blocks a major blood vessel, such as and the lungs. In cases involving an embolism, we always investigate the medical records and care to see if the OB/GYN, doctors, and other healthcare personnel used appropriate measures to avoid formation of blood clots. These may include compression stockings, sequential compression devices (SCD), and medications.
The second major cause of maternal death is hemorrhage, which accounts for 17% of the cases. A hemorrhage is a broad term that refers to excessive bleeding. In my experience, the most common type of maternal-related hemorrhaging results from a tear, cut, or damage to the uterus. This is a life-threatening situation that requires prompt recognition and treatment by the medical staff.
Pre-eclampsia and eclampsia are the third major type of maternal death, accounting for 16% of the cases. Pre-eclampsia is a sudden increase in the blood pressure of the pregnant mom after the 20th week of pregnancy. It is the most common complication for pregnant mothers. It typically shows up in the third trimester and affects around 5-8% of all pregnancies.
Pre-eclampsia risk factors include: (1) first-time mothers; (2) pregnant with multiple babies; (3) age younger than 20 or older than 40 years old; (4) high blood pressure or kidney disease before getting pregnant; (4) body mass index (BMI) of over 30; (5) previous experience with pregnancy-related hypertension or pre-eclampsia; and (6) relatives who had pre-eclampsia.
If pre-eclampsia is untreated, it can develop into a life-threatening condition called eclampsia, which can cause violent convulsions or seizures, coma, and even death. With good prenatal care, pre-eclampsia can usually be managed, minimizing the risk to the mother or baby.
The fourth main, infection, causes 13% of maternal death cases. Again, with proper prenatal care, most infections should be caught and treated before labor and delivery begins.
The final principal cause of maternal death, cardiomyopathy, causes about 8% of maternal death cases. Cardiomyopathy refers to a disease or weakness of the heart muscle.
How preventable is maternal death?
Most experts agree that over half of all of the birth-related deaths of mothers in the United States are preventable. From my experience, there are things that expecting moms can do to increase the safety of their babies and themselves.
First, if the mother has any high risk for pregnancy, ask the OB/GYN provider for a referral to an advanced practitioner called a maternal fetal medicine (MFM) specialist, also called a perinatologist. Maternal fetal medicine specialists are OB/GYN physicians with additional advanced fellowship training in managing high-risk pregnancies.
According to the U.S. National Institutes of Health, high-risk pregnancy risk factors include: (1) teen pregnancy; (2) first-time pregnancy after age 35; (3) high blood pressure; (4) polycystic ovary syndrome; (5) diabetes; (6) kidney disease; (7) autoimmune disease; (8) thyroid disease; (9) infertility; (10) obesity; (11) HIV/AIDS; (12) alcohol use or smoking during pregnancy; (13) pregnancy with multiple babies (twins, triplets, etc.); (14) gestational diabetes; and (15) pre-eclampsia and eclampsia.
Second, regardless of whether the mother is followed by an OB/GYN and/or a maternal fetal medicine specialist, keep all of the prenatal appointments. In addition, if there is any change in the mother’s medical condition, including getting a cold, having a fever, any new pains, or anything unusual, then the mother should be sure and tell the healthcare providers.
We are here to help
As a Houston, Texas medical malpractice lawyer, I have handled many cases involving birth injuries, as well as injuries and deaths of mothers during the labor and delivery process. In these complex cases, experience matters. For free consultation about your potential case, call Painter Law Firm, in Houston, Texas, at 281-580-8800.
Robert Painter is a medical malpractice and wrongful death attorney at Painter Law Firm PLLC, in Houston, Texas. He represents patients and family members in lawsuits, throughout the State of Texas, against hospitals, doctors, surgeons, anesthesiologists, pharmacists, and other healthcare providers. He is a former hospital administrator who speaks and writes frequently about healthcare and medical malpractice topics. He is a former editor-in-chief of The Houston Lawyer magazine, and currently serves on the editorial board of the Texas Bar Journal.