The United States (U.S.) has the highest rate of maternal mortality in the developed world, with U.S. mothers more likely to die from childbirth or pregnancy-related causes than other women. The U.S. maternal mortality increased 250 percent between 1987 and 2014 and has garnered the attention of health care providers, research and advocacy organizations, the Florida Department of Health, the Agency for Health Care Administration, and most recently, Congress.
Florida's 2017-2021 State Health Improvement Plan highlights maternal mortality as one of the most important health issues affecting Floridians. In addition, Congress passed legislation aimed at reducing the maternal mortality rate in 2018, and the U.S. House Ways and Means Committee sent inquiries to healthcare providers nationwide requesting information on efforts to reduce maternal mortality.
Of the estimated 700 maternal deaths occuring annually in the U.S., the Centers for Disease Control estimates that 60 percent are preventable. In fact, the Florida Department of Health's Pregnancy Associated Mortality Review identified post-partum hemorrhage, embolism and hypertension as the leading causes of maternal mortality.
Any childbirth can become high-risk during labor and delivery. According to the American Academy of Pediatrics, 10 percent of newborns require some level of neonatal resuscitation at birth and one percent require extensive resuscitative measures to survive. A recent American Journal of Obstetrics and Gynecology study states at least one unexpected complication was indicated on the birth certificate for 46 percent of all pregnancies.
The American College of Obstetricians and Gynecologist (ACOG) Levels of Maternal Care classification system does not provide recommendations for "Advanced Birth Center" facilities. ACOG has established levels of maternal care for birth centers and those recommendations do not include patients, complications or procedures deemed high risk, such as delivering babies in breech presentation, multiple births and cesarean sections. FHA recommends that advanced birth centers be co-located with a hospital to ensure rapid, quality responses to maternal and newborn emergencies that can arise even in deliveries considered to be low risk for complications. Highly specialized staff and facilities must be accessible within minutes of a life-threatening emergency.
For more information, contact FHA Vice President of Government Affairs Crystal Stickle.