Maternal Mortality – The Missing Indicator

By Megan Carolan, Director of Policy Research

As we wrapped up our South Carolina Early Childhood Databook
for publication, our team began to reflect on the process. We believe it’s
important to reflect on what’s not in the report that could have been included, and that we intend to include in
follow-up materials as well as in a future edition. Of course, we have to
balance the desire to be comprehensive with the logistics of data collection
and the risk of overwhelming the audience.

Perhaps the biggest gap in our data indicators is maternal
mortality. This wasn’t included in the 2014 edition of the report, and as a
result, was not on the original list for updates in the 2019 version. However,
throughout our planning conversations and consultations – this one just didn’t
enter the discussion. We do include infant mortality, which is of course the
starkest indicator of child wellness – but for an organization so focused on
two-generation impacts, we should have added maternal mortality alongside other
indicators such as prenatal care receipt and maternal depression. This omission
in our report somewhat reflects how maternal mortality has been treated in the
broader field of medicine and wellness. When NPR and ProPublica launched an
investigation into maternal deaths in 2017, they highlighted that the “inability,
or unwillingness, of states and the federal government to track maternal deaths
has been called ‘an international embarrassment.’”

This coverage launched an explosion of interest in the
topic. Google tracks the popularity of trends on its platforms, and here’s a
quick look at the growth in this term just since 2014 (the year of interest in
our last Databook). Interest has
doubled since early 2017 – when we began seeing a number of investigative
journalism pieces from major outlets on the topic, hitting its highest week of
interest yet the week of March 24, 2019.

Google Trend: Maternal Mortality

Legislators are stepping in to respond to this interest and
the dire statistics, rolling out new legislation to track these deaths
and find solutions. It’s a growing public policy topic and it will be in the next edition.

Of course, we determine our
research portfolio not simply based on what others in the field are (or, are
not!) talking about, but by the potential impact for children and the
opportunity for system-level improvements. Our commitment to equity demands we
look at this maternal mortality in-depth.

We pulled the data on maternal
mortality from United Health Foundation the same way
we would if it had been included in the data book, highlighting South Carolina,
Georgia, North Carolina, and the national average. The figures are stark.

Nationwide, 20.7 mothers die for
every 100,000 births from pregnancy-related issues. Both South Carolina and Georgia
mothers are faring worse than the national average – GA, in fact, has the
highest rate of maternal mortality in the nation. For Black mothers, the
situation is a crisis – in South Carolina more than 50 black women per 100,000
births are dying.  We pulled these data
from the United Health Foundation, who used a CDC dataset – and figures were
not even available for Hispanic women in SC and NC. The issues contributing to
maternal mortality are vast and require examination from all of our systems
serving families – we cannot afford to overlook this issue.

In a field as multi-dimensional as the well-being of
children and families, it is impossible to always capture all of the right data
– there’s just too many components to capture. However, our goal in creating
the data book is to provide a comprehensive picture of factors impacting
well-being and shine a light on commonly overlooked areas. Our future editions
will include maternal mortality, and we intend to utilize the findings shared
today in shaping our approach towards two-generation, upstream investment in
maternal care and pre-conception health.

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