Maternal Mortality Rates on the Rise in California, According to State Data

California's maternal mortality rates have nearly tripled during the past decade, according to an unreleased report from the state Department of Public Health, the Sacramento Bee reports.

California Watch, a project of the Center for Investigative Reporting, conducted the investigation into the state's pregnancy-related deaths.

California Rates on the Rise

In 1996, California's pregnancy-related mortality rate was 5.6 per 100,000 live births, slightly more than the national goal of 4.3 per 100,000.

After the World Health Organization revised its coding system, California's rate increased to 6.7 in 1998 and 7.7 in 1999.

California changed its coding system once more in 2003, and maternal mortality rates jumped to 14.6. In 2006, California's rate reached 16.9, compared with the national average of 13.3.

Investigators estimate that reporting system changes account for less than 30% of the increase in maternal mortality rates.

Nationwide Trend?

California might be mirroring the rest of the country with its rise in pregnancy-related deaths, according to a recent "Sentinel Event Alert" from the Joint Commission, a hospital accreditation organization.

On Jan. 26, the commission sent a notice informing hospitals that maternal mortality rates appear to be increasing nationwide.

Possible Contributing Factors

The Joint Commission suggested that diabetes, high blood pressure, hemorrhaging from caesarean sections and obesity could account for some of the increase in maternal mortality rates.

Elliott Main, principal investigator for California's report, said the rise cannot be fully explained by population changes such as fertility treatments, obesity and older mothers.

Main noted that c-sections also increased by 50% during the same decade that pregnancy-related deaths went up.

Currently, c-sections are the most common surgical procedure in the U.S. For hospitals, the surgery also brings in about twice the revenue of a vaginal birth.

Efforts to Reverse the Trend

In response to the rise in maternal mortality, California officials are starting work on pilot programs designed to:

• Improve hospital responses to hemorrhages;
• Reduce the incidence of induced births; and
• Strengthen tracking systems for women's medical conditions (Johnson, Sacramento Bee, 2/3).

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