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House of Representatives
Session of 2017 - 2018 Regular Session


Posted: September 7, 2017 03:02 PM
From: Representative Ryan E. Mackenzie
To: All House members
Subject: Maternal Mortality Review Committee
In the near future, I plan to introduce legislation establishing a Maternal Mortality Review Committee within the Pennsylvania Department of Health.

More women in the United States die from pregnancy complications than in any other developed country. Despite advances in medicine and medical technologies, the U.S. saw a 26% increase in the maternal mortality rate from 18.8 deaths per 100,000 live births in 2000 to 23.8 in 2014. Causes include preventable conditions like preeclampsia and obstetric hemorrhage. Mental health conditions including suicide and overdose, are the leading cause of maternal mortality in a growing number of states.

The Centers for Disease Control and Prevention (CDC) monitors maternal mortality on a national scale. The CDC provides technical assistance and guidance to help states establish maternal mortality review committees. These committees help to better identify pregnancy-related deaths, oversee the review of these deaths, recommend actions to help prevent future deaths and publish review results. This information helps clinicians and public health professionals to better understand circumstances surrounding pregnancy-related deaths and to take appropriate actions to prevent them. The CDC recommends that maternal deaths should be investigated through state-based maternal mortality reviews in order to institute the systemic changes needed to decrease maternal mortality.

At this time, no formal statewide process exists in Pennsylvania. Therefore, my legislation will establish a formal process to review maternal deaths in the Commonwealth. The creation of this Committee will play a critical role in ensuring that pregnancy-related deaths are identified and reviewed, and in catalyzing maternal mortality prevention initiatives among community stakeholders.

Currently 32 states, including the surrounding states of Delaware, Maryland, New Jersey, New York, Ohio and West Virginia have maternal mortality review committees either in operation or in development.

According to a 2016 report from America’s Health Rankings, based on CDC National Vital Statistics System data, Pennsylvania ranks 21 in maternal mortality. The maternal mortality rates in Massachusetts and California are among the lowest in the nation, ranking 1 and 2 respectively. The state of California speaks volumes to the success of implementing a maternal mortality review committee. In 2006 public health officials in California began studying the problem as they saw deaths rise. The California Pregnancy-Associated Mortality Review (CA-PAMR) identified cardiovascular disease, preeclampsia and obstetric hemorrhage as the leading causes of pregnancy-related deaths and initial findings of CA-PAMR were published in a statewide report and peer-reviewed journals. With data in hand about what was contributing to the risks of maternal mortality, Stanford University’s California Maternal Quality Care Collaborative (CMQCC), put together a series of toolkits to help guide hospitals in limiting complications and responding to emergencies. These toolkits are based on the state’s own data, as well as best practices. Since its inception, California’s maternal mortality rate declined more than 55% from 2006-2013, saving 9.6 lives per 100,000 – while the national maternal mortality rate continued to rise. 120,000 early births were prevented from 2009-2014, with an increase of 8% of births making it to full term. Maternal morbidity was reduced by 20.8% between 2014-2016 among the 126 hospitals participating in CMQCC projects to reduce maternal hemorrhage and preeclampsia.

Please join me in cosponsoring this important legislation.

Introduced as HB1869