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Tuesday, July 27, 2021

Pregnancy mortality rates in California triple since 1996, investigators say

The mortality rate of California women who die from causes directly related to pregnancy has nearly tripled in the past decade.

This is prompting doctors to worry about the dangers of obesity, high blood pressure and diabetes in expectant mothers and about medical complications such as hemorrhaging from Cesarean sections.

A study on pregnancy mortality rates conducted by the California Department of Public Health has doctors trying to figure out why pregnancy death rates are increasing.

Although the CDPH declined to release a report outlining the trend, investigators working on the study provided statistics from the report.

According to the investigative journalism web site Californiawatch.org, in 1996, the California maternal mortality rate was 5.6 per 100,000 live births, and rose to 16.9 in 2006. This is higher than the national maternal mortality rate of 13.3 per 100,000 in 2006.

Al Lundeen, deputy director and Office of Public Affairs at the CDPH, explained that the report cannot be released because it is still in preliminary stages.

“The maternal mortality report is in the review stage. Like all other reports at the CDPH, it is reviewed by other scientists and experts,” Lundeen said. “There is no set timeline for completion because it is impossible to predict what other changes or additional reviews may be necessary. CDPH standard review procedure is to produce a report that is complete and optimizes the health and well-being of Californians. That review is thorough and is not taken lightly. CDPH is committed to sharing this information with the public when it is completed.”

Dr. Elliott Main, the principal investigator for California Maternal Quality Care Collaborative, the public-private task force investigating the problem for the state, talked to Californiawatch.org.

Scientists have started to ask what doctors are doing differently, Main said. He added that it is hard to ignore the fact that C-sections have increased 50 percent in the same decade that maternal mortality increased.

According to the National Center for Health Statistics researchers, in 2006, 31.1 percent of births were by way of C-sections.

Tosi Marceline, a midwife in Davis for Birthstream Midwifery, believes the move toward more C-sections and hurried births is the primary reason for the increase in the death rate.

“You can’t increase the C-section rate without increasing the maternal mortality rate,” Marceline said. “Nobody knows what’s normal anymore. We live in a microwave generation culture. Everything is faster, but people have to realize that babies don’t come any faster and that our bodies work the same way they always have.”

Marceline disagrees with many of the reasons some are giving for the rise in deaths.

“The first article I read about it tried to do the classic thing and blame women for being too fat, old or diabetic,” Marceline said. “These reasons really can’t be used to explain the problem.”

Sacramento County Health Officer Dr. Glennah Trochet said there has to be more to the problem than C-sections, such as sexually transmitted diseases such as chlamydia, which can scar a woman’s fallopian tubes.

Teresa Forfythe, a labor and delivery nurse at Davis Sutter Health’s Birthing Center, said she believes it is difficult to tell the reason for the increase without looking at statistics of what is happening to individual mothers at the times of their deaths. She said an increase in illnesses could be contributing to this trend.

With so much concern for the issue, a national effort was developed to draw public attention to the maternal death rates and to underreporting of maternal deaths in the United States. The Safe Motherhood Quilt Project was created to honor women who have died of pregnancy-related causes since 1982.

The California task force is not waiting to determine the ultimate cause of these deaths. It has started pilot projects to improve the way hospitals respond to hemorrhages to better track women’s medical conditions and to reduce inductions.

ANGELA SWARTZ can be reached city@theaggie.org.

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