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Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees

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

#111

Post by ghufran_syed »

When a drug company does a study that shows that their drug helps some condition (and should therefore be bought by consumers and their insurance companies), we are naturally sceptical. But when a group of public health researchers "find" that spending more money on public health measures could "prevent" deaths, we somehow take it at face value.

The uk equivalent report is much more nuanced - note the use of "might have made a difference" vs "preventable":

"Mental health remains one of the leading causes of maternal death in pregnancy and the first postnatal year. Many of the women who died from suicide or substance misuse faced multiple adversity. Assessors felt that improvements in care might have made a difference in outcome for 67% of women who died by suicide, 29% who died from substance misuse and 18% of those who died by homicide. This report emphasizes once again the importance of immediate risk management and the potential for rapid deterioration, particularly postnatally. These messages are equally important across pregnant women of all ages, especially those who have had a pregnancy loss event, but this report does show a need for special attention around mental health for pregnant teenagers."

https://www.npeu.ox.ac.uk/mbrrace-uk/reports

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

#112

Post by spicybright »

mattmcknight wrote: post #64
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."

If "some chance" is taken to an extreme, I think there's potential to cloud the data so much it becomes almost useless.

Do they consider treatments that couldn't possibly be performed on every pregnancy that it might help? (due to finite medical resources, cost that insurance companies won't pay, etc.)

I'd much rather see a focus on the basics that other countries do that are consistently missed. Especially when it comes to over-using C-sections and how race plays into treatment.

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

#114

Post by maerF0x0 »

> Mental health conditions include deaths of suicide, overdose/poisoning related to substance use disorder, and other deaths determined by the MMRC to be related to a mental health condition, including substance use disorder.

(expecting)Mothers experience a lot of death from Mental health conditions because America experiences a lot of death from Mental health conditions. What I mean by this is that it's no surprise because it's widespread across the populace... now does it exactly line up with the expected rate for a random member of the population? IDK because I dont have those numbers handy.

But I thought that I'd point this out to indicate, we don't just need to help (Expecting)mothers but really the whole population deal with mental health.

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

#115

Post by runako »

notch656a wrote: post #108
coldpie wrote: post #50

Earlier quoted context omitted.

This is generally what advocates for these kinds of programs ask for. The bloat and overhead gets added by welfare opponents under the justification of "preventing abuse."

That's a bizarre take, although perhaps it is true. That WIC system is bloated and cost more because welfare opponents want it to be bloated? Is that anything more than a talking point -- I mean is there real evidence that anti-welfare people are voting in meaningful way to make the WIC program cost more? Personally I am against violence imposed welfare (taxation based). But I see cash remuneration as a win-win becau…

> That WIC system is bloated and cost more because welfare opponents want it to be bloated?

This is a very common tactic used by opponents of the US social safety net. Basically, the idea is to transform something that is broadly sympathetic to voters, like "giving money to poor moms so they can buy food for their kids, who otherwise will suffer from malnutrition" into something with no constituency, like "another Big Government Bureaucracy wasting your tax dollars." You can then attack the Big Government Bureaucracy without talking about the fact that you're effectively advocating for poor kids to go hungry.

The basic flow is you start with objections that sound reasonable to a set of middle-class voters: "we need to drug test the residents of public housing," or "we need to make sure they aren't buying sodas with Food Stamps," or "we need to have enforcers make in-person visits to ensure that they are as poor as they say" or whatever. You add in a bunch of those requirements over time. Eventually, you have created a bloated system that costs more while doing less for poor people (obviously, the money spent on the overhead is not available to buy food for hungry kids). And that bloated system is ripe for calls to be dismantled altogether.

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

#116

Post by [deleted] »

barsonme wrote: post #73
kevmo wrote: post #38

This is timely! I recently found out we are pregnant with our first child, and I spent a good amount of time looking up prenatal care in the USA. The statistics are staggering. USA has the worst infant mortality in the rich world. We spent 1/5th of our GDP on health industries, and we're getting nothing for it. Just a handful of really rich people.

But keep in mind this: > Upon examination, however, the discrepancy between the U.S. and other countries appears largely due to country-to-country differences in the way infant mortality statistics are compiled. Infant mortality is defined differently in different countries, and the U.S. definition is notably broader than that of most other countries. https://worldpopulationreview.com/country-rankings/infant-mo...

[deleted]

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

#117

Post by ghufran_syed »

CodesInChaos wrote: post #75
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…

What makes a medical error "preventable"?

When reading anything about medical error, it's important to try and distinguish between ex-ante and post-hoc analysis of what is preventable. Everyone can be a great coach after the "game" has finished

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

#118

Post by xupybd »

pyuser583 wrote: post #44
neves wrote: post #33

Earlier quoted context omitted.

One of main causes of abortion is high risk pregnancies. You are increasing the load with the most difficult and risk cases.

What % of abortions are due to high risk pregnancy?

The best I can find is one study suggesting 12% were for health related concerns.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3729671/

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

#119

Post by maerF0x0 »

ghufran_syed wrote: post #111

When a drug company does a study that shows that their drug helps some condition (and should therefore be bought by consumers and their insurance companies), we are naturally sceptical. But when a group of public health researchers "find" that spending more money on public health measures could "prevent" deaths, we somehow take it at face value. The uk equivalent report is much more nuanced - note the use of "might h…

I do still see those causes of death as preventable, just the prevention like starts many orders before the mother. Things like social safety nets which prevent crime and homicide, effective drug addiction treatment, and more generally giving people some hope instead of the endless negativity and nihilism that has been spread for at least six years now.

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

#120

Post by aeturnum »

fortran77 wrote: post #78

It's interesting that they don't discuss one easy way to prevent pregnancy complications for both mother and child: don't be obese or overweight See https://www.nature.com/articles/pr9201134 From the Nature article: "Obesity is associated with increased risk of almost all pregnancy complications: gestational hypertension, preeclampsia, gestational diabetes mellitus, delivery of large-for-GA infants, and higher incide…

People can always be healthier (and patients that meet weight-based diagnostic criteria are, AFAIK, informed about their elevated risk and advised to lose weight pretty reliably). I think this study seeks to identify additional intervention that would save lives with our current population - not project about how few people would die given some unrealized set of overall public health stats.
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