Maternal mortality in Texas - where are the pro-life Christians?

Dallas Morning News echo opinion editorial:

Also ~  Why is US infant mortality rate so high?  Sad and preventable! The US is 167th out of 224 countries monitored for number of infant deaths per 1,000 live births.

Texas lawmakers talked a good game about addressing the disturbingly high number of women who die each year in this state from pregnancy-related complications.

But after two years of acknowledging that the state has to do more to prevent dozens of deaths annually, we’re stunned that our representatives closed this legislative session without taking meaningful action to keep more moms alive.

Medical experts, health care advocates and the state’s Maternal Mortality and Morbidity Task Force backed a bipartisan bill that passed the Texas House that would have extended Medicaid coverage from the current 60 days postpartum to one year after a woman gives birth. It was the top recommendation from the task force after its investigation showed that most of the deaths occurred 61 days or more postpartum when most of the women have lost coverage — and most deaths were preventable. Shamefully, the bill didn’t even get a hearing in the Senate. 

Why study a problem for years, but then ignore an effective solution to fix it?  

Maine Writer  - In my opinion, this irresponsible hypocrisy is inexcusable and even sinful, because Texas Republicans are controlled by the pro-life anti-abortionists. Those crazy right wing nuts are obsessed with protecting the unborn, but they won't protect the health for mothers and babies, after they are born.About half of Texas’ 400,000 births each year are covered by Medicaid. We know that more prenatal care, more treatment for postpartum depression and more health screenings could save lives and make Texas babies healthier.

And task force research shows an appalling racial disparity of pregnancy-related deaths. The maternal mortality rate for black women in 2012 (studied because it was the year with the highest number of maternal deaths) was more than twice as high at 13.9 per 100,000 live births than the 6 for white women and 9.3 for Hispanic women.

They’re dying from such conditions as cardiac-related problems, infections, and suicide.

It’s even more alarming in the wake of a new national study from Georgetown University that put Texas dead last at 25.5 percent in the rate of uninsured women of childbearing age.

In a conference call with reporters, the researchers said when women abruptly lose health coverage so soon after giving birth, it can force them to abandon medication and other ongoing treatment they may need, including support for postpartum depression.

Gaps in coverage risk the lives of women and the health of their babies. States that have expanded Medicaid coverage have cut their maternal mortality rates in half.

A national health issue reported in St. Louis: an Echo

Maternal and Child Health data are among the earliest and most reliable indicators about the health of any given population of people.  Consequently, this important editorial published in the St. Louis Post-Dispatch gives cause for concern.
Echos - my re-blogs, opinions of interest, from St. Louis, Missouri:

Editorial: Why are there more maternal deaths in the U.S. than in other advanced nation?

Women in the United States are three times more likely to die during pregnancy and childbirth than women in Canada, five times more than women in the United Kingdom and six times more than women in Scandinavia. 

Maternal mortality has been in decline for years because of a concerted worldwide public health effort to address the problem. Yet the rate is increasing in America.

That’s appalling, especially considering the very high standard of medical care available in this country. Prospects are grim for improving health outcomes for pregnant women and those in childbirth because of the Trump administration’s $213 million in cuts for teen pregnancy programs, combined with efforts to defund Planned Parenthood, where more low-income women receive contraceptive and prenatal care than abortions.

Much of the problem is that the United States lacks a standardized care protocol for treating women with childbirth complications. The CDC Foundation, a public health care group funded by the Gates Foundation, said a recent analysis of maternal pregnancy-related deaths showed that nearly 60 percent were preventable.


U.S. Rep. Jaime Herrera Beutler, R-Wash., introduced the Preventing Maternal Deaths Act of 2017 in March. The measure would authorize funding for states to eliminate disparities associated with pregnancy-related deaths and improve health care quality for mothers. No Missourians are listed among the measure’s 59 bipartisan co-sponsors.

The legislation says the United States is ranked 50th globally for its maternal mortality rate and is one of only eight countries where the rate has been increasing. The rate rose 26.6 percent from 2000 to 2014, increasing in nearly all states. At the same time, the nation has reduced the infant mortality rate. The rate is at it lowest point ever, according to the Centers for Disease Control and Prevention.

More women die from pregnancy-related complications in the U.S. than in any other developed country, and most deaths result from hemorrhage, hypertensive disease and preeclampsia, a condition characterized by high blood pressure and damage to the liver and kidneys. Health studies show that black women are up to four times more likely to die from pregnancy-related problems than white women.


The death rates vary greatly in the United States and are particularly high in the District of Columbia, New Jersey, Georgia and Arkansas. The rate in Texas nearly doubled from 2000 to 2014.

Maternal mortality rates are dropping in California, which formed the Maternal Quality Care Collaborative in 2006 when deaths began rising. The partnership includes more than 40 public and private organizations that use data to improve outcomes for maternal and infant health.

Conservative politicians who claim to be “pro-life” should be the first to express outrage at the nation’s maternal mortality rate. Slashing funds for high-quality medical care to women is the opposite of a solution.

MaineWriter- Although I'm grateful to the St. Louis Post-Dispatch for bravely publishing this editorial, it strikes me as a public health policy failure that the Department of Health and Human Services, isn't leading a campaign, about this important health issue.

Maine rising infant mortality rates point to problems in northern Maine

Statement by Dr. Dora Mills

Dr. Dora Anne Mills of the University of New England was the Maine State Health Director from 1996 to 2011.

"I was shocked to learn that Maine’s rates are the only ones in the country that are increasing, i.e., worsening."

This is critical, because infant mortality – the rate at which babies die in the first year of life – is the most accurate pulse we have on the health of a society. 

It reflects not only the health of people at their most vulnerable time of life – that is, infancy – but also of women during and after pregnancy, and of the entire family and community, since any environmental toxin, public secondhand tobacco smoke, or other community-wide health issue often exerts their heaviest impact on infants.

I remember in the 1990s when Maine enjoyed the lowest – the best – infant mortality rates in the country, and was even on par with the lowest of any country in the world. So, I was stunned to learn that our rates have increased to the 43rd worst state in the country.

In digging into the data, I also learned not all of Maine has fared worse over the years. Compared with the 1990s, Maine’s more southern and urban infant mortality rates have stayed about the same, and in some cases even improved. For example, York County has seen a 31 percent improvement.

However, in most of Maine’s rural counties, the rim counties, rates have dramatically worsened. Some of these counties in Maine have infant mortality rates on par with Croatia, Romania, and Botswana. In other words, Maine’s worsening infant mortality rates seem mainly because of declining health of babies, families, and communities in rural Maine.

At first I thought maybe this decline was caused by one or two issues, such as the opioid addiction epidemic. So, I examined other health data, such as those for cancer, diabetes, drug addiction, heart disease, obesity and smoking, and compared county trends over the last 10-30 years. I learned that in most of these measures of health, rural Mainers are less well off than their more southern and urban counterparts, and are often worse off than several years ago. Any statewide declines in these issues over the last few years are often primarily because of worsening health of people in rural Maine.

As an example, death rates from cancer have declined across the country and state. However, mortality rates in rural Maine, which were already for the most part higher than the statewide rate, have not declined as much the last 10 years, causing an even wider gap, with rural Mainers dying from cancer at increasingly higher rates than their more urban counterparts. I also looked at childhood poverty, which is a barometer of the health of children in a community, since children living in poverty are more likely to be in poor health. Defined in 2015 by a household income less than $24,000 for a family of four (two adults and two children), poverty rates for children in Maine also vary widely by county, with rural counties faring worse and having worsened in the last 20 years. For instance, childhood poverty rates in Aroostook, Franklin, Oxford, Piscataquis, Somerset, and Washington counties are the highest in the state and have increased over the last 20 years.

By contrast, Cumberland and York counties have the lowest childhood poverty rates in Maine, and stayed about the same as 20 years ago. With the widening divide between rural and southern Maine, counties such as Piscataquis and Washington have childhood poverty rates approaching one-third of all children, and rates that are nearly three times that seen in York and Cumberland counties.

What can we do? The most critical step is to make sure Maine’s health care and public health systems across the state are sufficiently resourced to assure all Mainers have access to health care and live in healthy communities. This includes access to health care providers, health insurance (including MaineCare), public health nursing, community-based public health organizations, and governmental public health professionals at the regional and state levels. As a result, there should be readily available health care that includes drug and tobacco addiction treatments, sufficient preparedness for emergencies, and community-wide prevention on many issues such as nutrition education, cancer screening, and walkable communities. Because the economic health of a community is intrinsically related to its overall health, economic strategies that focus on rural areas are also important.

There is much beauty in rural Maine, found in its people, pristine lakes, mountains, woods and fields. However, just as we have built roads and power lines in rural Maine, we also must assure there are adequate pipelines to preserve and improve the health of those living there.

Vaccines now among the growing litany of anti-science movements

It's beyond belief to realize how many Americans are now falling victim to yet another anti-science movement. In fact, zealots who are "anti-vacccers" are employing scare tactics to push back decades of progress made by medical scientists who have saved countless numbers of lives because of the invention of preventative vaccines.

Yesterday's public hearings in Augusta Maine on May 11, 2015, heard a litany of testimonies from anti-vaccers who were roused by the daunting speech by Joesph Kennedy of Massachusettes. He took up time inciting anti-vaccers who want to push back the clock on the medical evidence in support of how vaccines prevent communicable diseases. Listening to Mr. Kennedy, one would take at face value that all vaccines are conspiracies by pharmaceutical companies to make money by adding deadly ingredients to their products so they will be cheaper, albeit dangerous. If his wrong minded allegations were true, none of us who were in the room yesterday would be alive today. Moreover, everyone who testified against the vaccine expansion bills told the Maine Health and Human Services Committee that they were vaccinated and their children were, also.

Here is testimony I helped to craft with Avanel Payne, R.N., B.S. C.P.N. (Certified Pediatric Nurse): Thank you Avanel.

(Right) Avanel Payne, a certified pediatric nurse with Dr. Norma Dreyfus a retired pediarician (left)in the Maine Cross Building Health and Human Services Committee Room they supported LD 471  (photo by Juliana L'Heureux0

May 11, 2015  Testimony of Avanel Payne, R.N., B.S.N. C.P.N. (Certified Pediatric Nurse) Washington Street, Bath, ME 04530

In support of LD471: An Act to Improve Vaccination Rates in Maine

Good Morning,

Chairman Senator Brakey

Chair Representative Grattine

Members of the Health and Human Services Committee

My name is Avanel Payne. I’m a practicing Registered Nurse living in Bath, ME.

I’ve been a nurse who cares for Maternal and Child Health and pediatrics patients for over 30 years. I work in Mid Coast Maine.

I’m supporting LD471: An Act to Improve Vaccination Rates in Maine.

This is an important piece of legislation. Let me tell you why I feel strongly about supporting vaccines for children and their effectiveness in protecting the public’s health.

I practiced nursing in the years prior to having vaccines available for contagious diseases like measles, mumps, and chicken pox. Frankly, I remember when the polio vaccine became available, when I was a student nurse at the University of Pennsylvania.

Before vaccines were available, when measles broke out in schools, not all the children recovered. I’ve seen children with measles encephalitis, which has a high rate of mortality. I have seen patients surviving in iron lungs because they became ill with the polio virus. Today, these diseases are entirely preventable because of the availability of vaccines.

I have cared for children who have compromised immune systems because they are receiving immuno suppressive therapy due to cancers or as recipients of organ transplants. It’s vitally important for these children to receive vaccines, especially the varicella vaccine to prevent chicken pox. Sadly, when a child becomes ill with chicken pox and has a weakened immune system, the disease is often deadly, but it can be prevented with the varicella vaccine. When all children receive the varicella vaccine, the cumulative effect protects everyone from the spread of this communicable disease.

Protecting the entire community with vaccines has the benefit of helping children who have suppressed immune systems.

I also support the policy of providing Hepatitis B for all newborns, because this vaccine prevents children from growing up with chronic liver disease.

Protecting the public from preventable infectious diseases is our first public health obligation. When we protect the public from becoming infected with preventable communicable diseases, we are also protecting the quality of life for all Maine citizens and the health of our workforce.

As a matter of fact, when the public is healthy and protected from the risk of preventable infectious diseases, like measles, mumps, pertussis, polio, hepatitis, meningitis and chicken pox, we can provide for a healthier education system, because the children will not miss school due to preventable illness and parents will not worry about missing work when their children are ill or at risk of becoming ill with infectious disease, during the epidemic outbreaks.

Moreover, in my experience, I have never seen any child with autistic syndrome that can even remotely be correlated with a vaccine.

On the other hand, I have cared for many children who were infected with vaccine preventable illnesses who suffered because there was no vaccine available or they did receive the benefit.

I urge you to support vaccine availability for all people, especially children. It’s proven to be a cost effective wellness policy that benefits everyone equally.

Thank you for the opportunity to speak on a public health policy that I feel strongly about and I know will improve the wellness of Maine people.