The journey to improving maternal health outcomes

I was lying on this cold table in the delivery room that early Sunday morning in 1992. I just gave birth to a baby. I still didn’t know if it was a boy or a girl. I heard it cry, and then the nurse took it away. Then I heard the doctor say there wasn’t any available bed for me. Later, my sister helped me get up, and we walked out of the delivery room into a hallway. I recognized my mother’s loincloth lying on the floor. My sister then helped me lie down on it. The floor was hard and cold. Later, the nurse brought my baby and put her next to me. It was the first time I looked at her … yes it was a girl.

Soon, I heard a dripping sound. I looked to my left and saw a small bed in a room across the hallway. I could see the dripping coming from under the bed. I could see a pool of blood on the tiled floor. I was shocked. I couldn’t fathom blood running through the patient’s clothes, bed sheets and mattress continuously dripping. It was the maternity wing of the biggest hospital in town. I lifted my head to see if the patient was receiving treatment. I didn’t see any IV, no blood transfusion, and no one by her side. I later found that the patient had given birth the night before. The baby didn’t make it, and the mother was hemorrhaging.

Later when my mother arrived and witnessed me and her granddaughter lying down on the tiled floor and the pool of blood under the other patient’s bed, she requested that I be discharged immediately. I never found out if that woman made it or not. This was in 1992, in West Africa.

More than 30 years later, the CDC's National Center for Health Statistics released 2021 maternal mortality data showing an alarming trend of increased maternal mortality rates in the U.S. and persisting disparities. While my story is indeed horrific, I tell it to underline the fact that we are still struggling, as a first world country, to provide safe maternal care. Maternal mortality rates have increased by 89 percent since 2018, with a 38 percent increase from 2020 to 2021. Non-Hispanic Black birthing people face rates 2.6 times higher than their white peers.

Could the issue be access to good health care? It could, but a recent study conducted by Surgo Health, the first to apply a geographic lens to maternal mortality disparities, reveals how “even in less vulnerable areas, Black women were at higher risk of maternal mortality than white women who lived in more vulnerable locations.”

This revelation unveils the need to address these inequities and demand change. That’s why I’m so proud to work for a company that creates solutions to help organizations identify and trend risk-adjusted maternal outcomes.

A payer recently told me that sometimes they don’t know their member is pregnant until the baby is in the NICU. With the right technology, providers, health plans and payers can proactively identify intervention opportunities and take the appropriate actions.

Quality methodologies can provide insight into the lack of access to high quality outpatient care or care coordination. This tool tells the antepartum care story. The health system wants to avoid complications and improve health outcomes. The payer would like to prevent or reduce unnecessary costs. These methodologies put into perspective every aspect of the delivery process. They highlight preventable factors, specifically failure to identify high risk status and delays in diagnosis and treatment.

Finally, technology can help unravel the quality of care or lack thereof, during the initial delivery hospital stay. Both providers and payers want to focus on this because readmissions serve not only as quality screens but are also expensive, representing a disproportionate share of expenditures for inpatient hospital care.

Whether giving birth in West Africa or the United States, it is critical that we reduce preventable maternal morbidity and disparities in health care outcomes. Maternal health care is primary health care.

Flora Coan, regional manager at 3M Health Information System specializing in business development with government agencies.