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June 28, 2022

Addressing Indiana's Maternal Mortality Rate

Addressing Indiana's Maternal Mortality Rate

Indiana has one of the highest maternal mortality rates in the United States, and a group of experts in the state across many fields are working together to address this complex issue.

Maternal mortality is defined as the death of a person during pregnancy or up to one-year post-partum that is due to a cause related to or made worse by the pregnancy. Among states that report data, Indiana ranks 3rd worst for maternal mortality.

Because of this high ranking, Indiana created the Maternal Mortality Review Committee (MMRC) in 2018. The MMRC includes physicians, social workers, psychologists, nurses, and others. This diverse group of people brings different perspectives to case reviews.

What Causes Indiana’s Low Ranking?

Why maternal mortality is particularly challenging in Indiana is a difficult question. But the diverse perspectives have allowed the MMRC to zero in on some specific issues and create recommendations that could decrease those figures. Dr. Caroline Rouse, a Riley Children's Health maternal-fetal medicine physician and member of the MMRC shared several:

  • Early pregnancy care: The MMRC data from the last couple of years has shown there are higher percentages of patients who did not have access to early pregnancy care which results in maternal mortality, she said.
  • Prenatal care deserts: Counties that do not have a delivery hospital or any prenatal care providers result in a higher rate of maternal mortality based on the number of people in those counties. If a patient cannot access care, they are not able to see a provider that will help identify risk factors in their history, Rouse said. If the providers in the county are not familiar with working with pregnant or post-partum people, this increases the risk of complications that could occur. Rouse said they are seeing this happening.
  • Racial and ethnic disparities in health care: “People's racialized experience in medicine impacts how they access care, whether or not they access care, how they experience the care they get, what they do with the care they get,” Rouse said. It is important to be mindful – even within this general devastating category of maternal mortality—there are some communities that are much more affected than others, she said. It is an important factor as well in searching for answers and ways to decrease mortality.

What Should Someone Who is Pregnant Know?

Dr. Rouse emphasized that “advocating for yourself and feeling comfortable bringing up concerns” is the first step.

Pregnancy is an anxiety-provoking time for a lot of people. Most of the time concerns that people are feeling end up just being part of a normal pregnancy – but sometimes it's not. With that said, it is important for pregnant people to work with their care provider, to be honest about things that are happening and concerns they have.

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Caroline E. Rouse, MD

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