Missouri investing millions to reduce maternal mortality rate

JEFFERSON CITY, Mo. – The state is making a historic investment in a maternal mortality prevention plan after Missouri has one of the highest rates of pregnancy-related deaths in the country.

In a new report from the state, an average of more than 60 Missouri women died while pregnant or within one year after giving birth between 2018 and 2020. Those in the medical field say the most sobering piece of the report is that nearly 85% of those deaths were preventable.

“It didn’t happen overnight, and it didn’t happen from one single cause,” Department of Health and Senior Services Maternal Child Health Director Martha Smith said. “It has happened over years and there are many different contributing factors.”

Missouri is looking at new ways to help save new moms. According to a recent report from the state’s Pregnancy-Associated Mortality Review (PAMR) Board, the number one cause of pregnancy-related deaths was mental health conditions, including substance use disorders.

After lawmakers and the governor approved spending $4.3 million this year in a new investment to reduce maternal mortality in Missouri, both the Department of Health and Senior Services (DHSS) and the Missouri Hospital Association (MHA) are teaming up in hopes of turning the tide.

The plan includes five domains:

• Missouri Maternal Quality Care Protocols: Develop and implement standardized evidence-based protocols for maternal-fetal health care with toolkits which include articles, care guidelines, a hospital-level implementation guide and professional education materials

• Maternal Care Workforce: Develop standardized maternal care provider trainings on trauma-informed, responsive, culturally congruent and linguistically appropriate care, which includes screenings, referrals and treatment of mental health conditions and substance use disorders.

• Optimize Postpartum Care: Developing a postpartum plan to include an assessment for depression and anxiety and, as appropriate, referrals to mental health professionals and social workers

• Maternal Health Access Project: The state is working with the University of Missouri Health System to develop a Perinatal Health Access Collaborative providing same-day consultations, patient referrals to community services and over-the-phone follow-up care for mental health. It’s being called the “Missouri Perinatal Psychiatric Access Project,” known as MO-PPAP. Those behind the effort at the University of Missouri believe it will be helpful to providers like OBGYNs and midwives to give the best mental health resources to their patients. With money from the Department of Health and Senior Services (DHSS) and the federal government, the University of Missouri is creating a new tool to help providers. MO-PPAP offers providers a consultation over the phone with a perinatal psychiatrist, who will then provide a treatment plan within 30 minutes.

• Improved Maternal Health Data: The state will create a maternal-child health dashboard to advance data quality and accessibility.

This all comes after Gov. Mike Parson said earlier this year he was heartbroken to learn the state is failing in maternal mortality.

“This is embarrassing and absolutely unacceptable,” Parson said during his annual State of the State address. “We are determined to change this.”

Earlier this year, a new law went into effect extending Medicaid coverage for new moms for up to one year after the baby is born. By extending postpartum coverage, it’s estimated that this will help more than 4,200 women a year.

“We’ve got to raise the standard, the minimum standard, of quality and ensure that every single woman, preconception, during pregnancy and postpartum, has access to quality health care services,” Smith said.

Many of these programs are still being developed but the General Assembly is expected to continue to appropriate money for these investments.

The report also found that women living in metropolitan counties were almost twice as likely to die of a pregnancy-related death as women in rural counties.

Since 2014, roughly 20 Missouri hospitals have closed, leaving 50 rural counties without a hospital. Nearly all of those closures are because of financial problems or a lack of workers—the same reasons why hospitals are shutting down labor and delivery units.

Click here to see the full 2018-2020 PAMR Board report.

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