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Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees

cdc.gov

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Re: Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees

#61

Post by kube-system »

smeej wrote: post #53

I'd like to know more detail about the methodology and definition of "preventable." My sister's death in 2017 while 8 months pregnant is (apparently) included in this data, but I wonder how they would rate it. She experienced sudden cardiac death, but had no prior indication anything was wrong with her heart, and no symptoms that would otherwise cause someone to examine her heart. Had anyone examined it, they might h…

From the article:

> A death is considered preventable if the committee determines that there was at least some chance of the death being averted by one or more reasonable changes to patient, community, provider, facility, and/or systems factors. MMRIA allows MMRCs to document preventability decisions in two ways: (1) determining preventability as a yes or no, and/or 2) determining the chance to alter the outcome by using a scale that indicates no chance, some chance, or good chance. Any death with a yes response or a response that there was some chance or a good chance to alter the outcome was considered preventable. Deaths with a no response or no chance were considered not preventable.

Re: Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees

#62

Post by disabled »

smeej wrote: post #53

I'd like to know more detail about the methodology and definition of "preventable." My sister's death in 2017 while 8 months pregnant is (apparently) included in this data, but I wonder how they would rate it. She experienced sudden cardiac death, but had no prior indication anything was wrong with her heart, and no symptoms that would otherwise cause someone to examine her heart. Had anyone examined it, they might h…

There are amenable and non-amenable medical errors.

The above article is describing amenable medical errors. I don’t want to make assumptions about how your sister’s death would be classified.

However, I am so sorry for your loss, which is a tragedy. We need to do better, as this should not be happening.

Re: Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees

#63

Post by saiya-jin »

dane-pgp wrote: post #35
malfist wrote: post #2

Maternity healthcare in the US is one of the worst in the developed nations. And yet we're banning abortion, and doing nothing to fix it. Even WIC has came under attack in the past. Protecting the unborn is very convenient. They make no demands of you. Edit: WIC: Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) https://www.fns.usda.gov/wic

I completely agree with you, except I think the middle line of your comment is needlessly snide. One could equally say: "Protecting unborn (and newly born) humans is very inconvenient. They make all sorts of demands of you. (So maybe we should deny their humanity.)" The real questions are "At what point does human life begin / become valuable?" and "Should governments provide for their citizens or merely punish those…

You can't reach middle ground if you have religious fanatics who feel righteous above everybody else and keep pushing their values unto all. This is valid in any religion, and can be currently seen causing havoc among christians and muslims alike.

They can shield themselves by extremist interpretations of 'word of god' (which takes some mental gymnastics since his are, if at all, only 10 commandments and thats it, rest is just human-made stories). Funnily most of those folks fail with following even those 10 basic rules, but thats another topic.

We went through this decades ago in Europe and largely emerged as better, more democratic and freer societies. Those times are regarded as dark primitive times when looking back, when a lot of trauma was done and a lot of regretful actions happened.

Re: Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees

#64

Post by mattmcknight »

simonsarris wrote: post #21

Reminder when comparing with other nations that as this study states: "Pregnancy-related deaths occurred during pregnancy, delivery, and up to a year postpartum. " The measure can be very different elsewhere. The WHO defines a maternal death as "the death of a woman while pregnant or within 42 days of termination of pregnancy , irrespective of the duration and the site of the pregnancy, from any cause related to or a…

Also, mental health conditions and cardiomyopathy are "preventable"? Their definition of Preventability stretches credibility- lowering the risk is different from preventing something.

"A death is considered preventable if the committee determines that there was at least some chance of the death being averted by one or more reasonable changes to patient, community, provider, facility, and/or systems factors."

Re: Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees

#65

Post by csdvrx »

StormChaser_5 wrote: post #41
csdvrx wrote: post #27

It's a theoretical claim (unproved, as acting on a system changes the system) Also, it's missing the crucial implication: at what price? With infinite amount of money, there are many things we could do. We don't have infinite money. Consider how the richest EU state in adjusted PPP per capita (so price levels can't be blamed) is just now barely richer than the poorest US state, in both the median and average Do we re…

Not sure where you ate getting that comparison. 2 mins on Google tells me [1] that ireland for example has a ppp per capita gdp of 79k vs USA average of 63k. Which would seem to imply that the first country in EU I compared with is significantly higher than at least some of us states? And that isn't a recent development. The choice isn't about getting massively poorer, it's just whether you want to be able to look yo…

Average hides things. Talk about medians AND averages: the former doesn't change if Jeff Bezos enter the room. The later will.

Also talk about ajusted PPP, to account for higher or lower local costs (and accounting shenanigans like double irish with dutch sandwich)

When not cheating, US is #2, only behind Luxembourg, even if my local observations do not support this conclusion:

https://en.wikipedia.org/wiki/Median_income

Re: Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees

#66

Post by [deleted] »

kube-system wrote: post #42
andrewla wrote: post #23

This article is disturbing on many levels. The sound bite that the US has a problem with maternity healthcare is ingrained, but this makes me take a second look. First is that we report maternal mortality even when not directly associated with birth -- "Among pregnancy-related deaths with information on timing, 53% occurred 7–365 days postpartum." Is that standard for reporting countries? Is our problem with maternit…

Drug use is a huge issue in the US, and people who struggle with addiction (and associated mental health) are also more likely to get into situations where unplanned pregnancies happen. This isn't as much of a problem with maternal care as it is a problem with drug addiction, and this is simply the downstream consequence of that.

[deleted]

Re: Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees

#67

Post by xyzzyz »

disabled wrote: post #56

The third leading cause of death in the United States is believed to be preventable medical errors. Anyways, I have never been pregnant, but if you saw what happened to me medically this summer, you would be doing everything you could to be leaving the US. Anyways, I am a dual citizen. My other nationality is Croatian, but I don’t plan on living there. Even Croatia, you know which went through a horrific war 30 years…

I imagine life expectancy in Croatia would be much worse than in US if Croatians were as overweight as Americans are, and used hard drugs or lived on the streets as often. Fortunately, Croatians tend to live much healthier lifestyles than Americans, which results in higher life expectancy, despite available medical care being of worse quality.

Re: Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees

#68

Post by notch656a »

a4isms wrote: post #57
echelon wrote: post #46

Earlier quoted context omitted.

> dies 8 days later due to complications But 365 days? That's sounds like it's mental health related. It seems like we should track cause of death so we can have richer and more actionable information. Edit: I didn't mean to imply that this wasn't postpartum depression. I was curious if/why other nations aren't tracking the full calendar year after birth, and if our way of counting prevents us from directly comparing…

Postpartum depression[1] is an example of a something that is _both_ "mental health related" and "pregnancy related." https://en.wikipedia.org/wiki/Postpartum_depression

It's interesting they include things such as all suicides as pregnancy related death, though. If someone commits suicide 11 months after the kid is born there's no guarantees the reason was the pregnancy or the kid. It's possible but we can't really say that must be it.

Re: Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees

#69

Post by j_walter »

kube-system wrote: post #42
andrewla wrote: post #23

This article is disturbing on many levels. The sound bite that the US has a problem with maternity healthcare is ingrained, but this makes me take a second look. First is that we report maternal mortality even when not directly associated with birth -- "Among pregnancy-related deaths with information on timing, 53% occurred 7–365 days postpartum." Is that standard for reporting countries? Is our problem with maternit…

Drug use is a huge issue in the US, and people who struggle with addiction (and associated mental health) are also more likely to get into situations where unplanned pregnancies happen. This isn't as much of a problem with maternal care as it is a problem with drug addiction, and this is simply the downstream consequence of that.

My mother was a doctor that spent a great deal of time with expectant mothers. Based on her limited but also extensive experience on the subject drug use by the mother caused a significant portion of the mortality in unborn fetuses. This was particularly seen higher in the minority population (Black, Native American, etc.) and she is frustrated when she sees all the statistics that racism is the only reason behind the minority fetal mortality rate being higher than for Caucasians. They don't ever account for decision making in those studies and even in this study I'm sure drug use is considered a "preventable condition".

Re: Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees

#70

Post by dominotw »

neves wrote: post #29
andrewla wrote: post #23

This article is disturbing on many levels. The sound bite that the US has a problem with maternity healthcare is ingrained, but this makes me take a second look. First is that we report maternal mortality even when not directly associated with birth -- "Among pregnancy-related deaths with information on timing, 53% occurred 7–365 days postpartum." Is that standard for reporting countries? Is our problem with maternit…

USA is the richest country of the world and does not have paid maternity leave. It is very weird and my hypothesis is that this fact relates to these mental health conditions.

> my hypothesis is that this fact relates to these mental health conditions.

how though. Mothers go down the path of abusing substances because they know they wont paid get days off at work?

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