In Washington state, the rate of pregnancy-related maternal deaths is 9 in 100,000 births, compared to 17 per 100,000 births in the rest of the country.
In 2016, the Washington Maternal Mortality Review was established through Senate Bill 6534. It resulted in a report on maternal deaths from 2014-2015.
The report found 69 maternal deaths. Of those 69, 16 were determined to be pregnancy related. That means the death was directly caused by pregnancy or a chain of events that started during pregnancy.
"We found that hemorrhage, that's excessive blood loss during pregnancy, and hypertension, that is high blood pressure during pregnancy, childbirth or after pregnancy were our leading causes of death,” Lacy Fehrenbach, director of the Office of Family and Community Health Improvement at the Washington State Department of Health, explained.
Of the pregnancy-related deaths, the state found that half were preventable.
"There were missed opportunities in our state, and some of these women would still be alive with us today if they had received a phone call or perhaps a visit from a nurse in the days shortly after returning home from the hospital."
She said, like the rest of the country, the state sees an increased rate of pregnancy-related deaths for women of color.
"We also know that we all have biases, and when people of color interface with the healthcare system and the social service system, those biases impact how they receive care and how they receive services. So, we have to pay attention to that and start working to address disparities both inside clinics and outside of clinical walls,” she said. “If we really want to make a difference in the gap we see between health outcomes for -- in this case between white women and women of color."
Fehrenbach says training is needed around disparities in the healthcare system.
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Senator Patty Murray calls the rate in Washington unacceptable.
“I have heard anecdotally from African American women that often times when they tell a doctor a certain symptom they are dismissed and not listened to. If that's the case, we need better training,” said Murray.
She wants all states to review maternal deaths to better understand why rates in the U.S. are so high.
This year, the Senate passed a spending bill that Murray championed with a $50 million investment to address maternal mortality. The new funds will expand data collection efforts, support evidence-based programs to prevent maternal death, and improve care across clinical and public health systems.
The investment includes $12 million to allow the CDC to support state efforts to establish and strengthen maternal mortality review committees that investigate deaths associated with pregnancy.
"I don't want any other moms in our country, anyone, to die an unnecessary death having a baby. But the fact is we need to gather the data first, and we need to answer the questions of why this is occurring and then focus our resources and our education in the right place to change this. That is what I am doing,” Murray said.