Alarming increase in maternal mortality rate

February 2, 2010 11:53:31 PM PST
Women across California are dying during childbirth in alarming numbers. Three times as many expectant mothers have died in just the past decade. But why? That's the question California Watch, a project of the Center for Investigative Reporting, is asking.

The number of deaths is relatively small, but still the spike in the maternal death rate is alarming to those in public health. In fact, it is more dangerous to give birth in California than it is in Kuwait or Bosnia.

Tatia Oden French died in childbirth nine years ago after having an adverse reaction to the drug used to induce her.

"She was about two weeks overdue and her doctor wanted to induce her," said French's mother, Maddy Oden of Oakland. "They ultimately did an emergency c-section and she died and the baby died."

Turns out, more pregnant women in California are dying from causes directly related to pregnancy. It has caught the attention of the State Department of Public Health which formed a group to investigate. What they found was surprising.

In 1996 for instance, the maternal death rate in California was 5.6 per 100,000 live births. Since then, it has steadily gone up. In 2006, the maternal death rate was 16.9 per 100,000 live births.

"We haven't seen these rates of maternal death since the 70s," Christine Morton of California Maternal Quality Care Collaborative said. "You don't expect childbirth outcomes to go backward. That's concerning."

Morton is on the committee investigating the higher death rate. She says they are still reviewing the data so it is too soon to point to causes. But she says some of the increase is attributable to better reporting on death certificates. The rest is likely the result of a variety of factors.

An important point is that many deaths were the result of hemorrhage.

"We do know that c-sections have risen dramatically in the last 10 years," Morton said. "We know that with more c-sections there's more likelihood of placenta abnormalities that can cause problems including hemorrhage."

The task force has already taken action. It is working with hospitals to improve response to hemorrhages and to be more cautious with inductions.

It is something Oden says is a good idea.

"I personally believe from my research and my experience that a lot of it has to do with the interventions that are not necessary at the time in birth," she said.

The task force is also looking into morbid obesity, high blood pressure and diabetes as possible contributing factors.

More on this story from California Watch, a project of the Center for Investigative Reporting: