A nonprofit publication of the Kentucky Center for Public Service Journalism

Mental Health services needed to curb Kentucky’s high rate of maternal deaths, says new report

By Sarah Ladd
Kentucky Lantern

This story discusses suicide and mental health. If you or someone you know is contemplating suicide, please call or text the National Suicide Prevention Lifeline at 988.

At least 8.4% of Kentucky’s maternal deaths between 2017 and 2019 were from suicide, according to a new state report presented to the Senate Standing Committee on Health Services last week.

That number could be higher, though, according to Dr. Jeffrey M. Goldberg, the legislative advocacy chair for the Kentucky chapter of the American College of Obstetricians and Gynecologists (ACOG).

Getty Images via Kentucky Lantern

More than half – 53% – of deaths ruled accidental during those years had a contributing factor of substance use. Goldberg said some of these deaths could have had “a component of self harm.”

The top reason for hospital readmission in the 90 days after birth among Medicaid patients, he added, was suicidal ideation.

Additionally, more than 90% of the state’s maternal deaths are preventable, said Goldberg.

“To me that is a shocking statistic,” Goldberg told legislators. “Nine out of every 10 maternal deaths need not have happened if we had the right systems in place.”

Racial disparities within this data are being examined but such a report isn’t yet available, he told legislators.

Deaths from pregnancy increasing nationwide

A 2022 March of Dimes report showed deaths from pregnancy are increasing in the United States, which already has one of the highest maternal death rates among high-income countries.

The Kentucky Lantern previously reported around 900 women in the U.S. died from pregnancy-related issues in 2020, up 14% from 2019 and up a whopping 30% from 2018.

Pregnancy is especially dangerous for Black Americans, who are three times more likely to die from pregnancy than white people. White women are also more likely to have access to good prenatal care than Native, Black, Pacific Islander, Asian and Hispanic women.

The maternal mortality rates are rising. A 2021 report from the Cabinet for Health and Family Services showed Kentucky’s maternal deaths increasing from 45 in 2013 to 61 in 2019.

“If you’re 25 years old and pregnant today, you have a higher chance of dying from your pregnancy than your mother did when she was pregnant with you 25 years ago,” Goldberg said. “That’s completely unacceptable.”

What are the next steps?

Goldberg said next steps should include mandatory participation in the nationwide Alliance for Innovation on Maternal Health Patient Safety Bundles.

A Republican-sponsored house bill would remove the state’s barriers to opening freestanding birth centers, staffed by midwives and supported by holistic birthing organizations.

Sen. Shelley Funke Frommeyer, R-Alexandria, has filed companion legislation in the Senate. She asked Goldberg if birthing centers had a role in addressing maternal mortality.

“Absolutely. Basically, every facility or program that is involved in providing health care for pregnant women needs to be part of this process,” replied Goldberg.

“Birthing centers are a component of obstetrical care in the United States. They are an option for where to give birth, and they absolutely need to be part of the process of making sure that we are bringing all the tools necessary to help prevent morbidity and mortality.”

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