Texas Releases 2024 MMMRC Report
The Texas Maternal Mortality and Morbidity Review Committee (MMMRC) released their 2024 report that highlights concerning trends in maternal health, revealing that 80% of pregnancy-related deaths in the state are preventable. The findings point to systemic issues, including a lack of access to quality maternal care, racial disparities, and insufficient postpartum support, which are critical in addressing maternal mortality in Texas.
According to an article from the Associated Press and the Texas Tribune, “The rate of Texas women who died because of pregnancy or childbirth rose sharply in 2020 and 2021 to the highest since the state started tracking maternal deaths in 2013. Even excluding deaths related to COVID-19, the numbers were worse than usual, reversing two years of progress in driving the maternal mortality rate downwards.
The Texas Maternal Mortality and Morbidity Review Committee released its report this month analyzing pregnancy-related deaths within one year of childbirth. The committee, which works on a several year delay, closely analyzed cases from 2020.
The maternal mortality rate in 2020 was 27.7 deaths per 100,000 live births, compared to 17.2 in 2019. With COVID-related deaths excluded, the rate was 24.2.
But the report shows, once again, that maternal mortality does not impact every community equally. Black women are about 2.5 times more likely to die from pregnancy and childbirth than white women. Both Black and Hispanic women saw a sharp increase in pregnancy-related mortality between 2019 and 2020 — for Hispanic women the rate increased nearly 9 points to 22.2, and for Black women more than 11 points to 39. But white women actually saw an improvement, with the mortality rate dropping nearly 3 points to 16.1.”
Recommendations from this report fall heavily on improving health care, increasing access to care, increasing culturally congruent care, and addressing social determents of health.
Summary of Findings:
42 percent of pregnancy-associated deaths from the 2020 case cohort were pregnancy-related.
Most pregnancy-related deaths were preventable.
Six underlying causes of death accounted for 78 percent of all 2020 pregnancy-related deaths.
Multiple underlying conditions contributed to pregnancyrelated deaths due to infection, cardiovascular conditions, and obstetric hemorrhage.
The MMMRC has identified key circumstances surrounding death contributed to pregnancy-related deaths.
A complex interaction of factors and characteristics contribute to preventable death.
Compared to 2019, the 2020 Texas pregnancy-related mortality ratio increased, and disparities persisted, with non-Hispanic Black women, older women, and women with a high school education or less being most disproportionately impacted.
Preventability varied by underlying cause of death and across years.
Timing of death in relation to pregnancy varied by underlying cause of death.
The leading causes of pregnancy-related death varied by race and ethnicity.
Most pregnancy-related deaths occur in hospitals except for deaths due to mental health conditions.
A complex interplay of factors contribute to preventable pregnancy-related death.
Summary of MMMRC Recommendations:
Improve access to comprehensive health services for all women of childbearing age, including preconception, pregnancy, postpartum, and interpregnancy periods; facilitate continuity of care; implement effective care transitions; and promote safe birth spacing to reduce gaps and improve lifelong health.
Prioritize resources and treatments for pregnant and postpartum patients in future public health emergencies based on the consistent pattern of increased morbidity, mortality, and susceptibility in this population.
Engage Black communities and address health disparities in maternal and women’s health program development.
Implement and amplify provider awareness of and participation in statewide maternal health and safety initiatives to reduce maternal mortality, morbidity, and health disparities.
Increase public awareness and community engagement to foster a culture of maternal health, safety, and disease prevention.
Improve integrated behavioral health care access for reproductive age women with mental health and substance use disorders. 3
Improve infrastructure and programs to address violence and intimate partner violence at state and community levels.
Foster safe and supportive community environments to help women achieve their full health potential.
Support emergency and maternal health service coordination and implement evidence-based, standardized protocols to prevent, identify, and manage obstetric and postpartum emergencies.
Improve postpartum care management, including education and health care coordination for those with mental health and/or high-risk medical conditions.
Prioritize continuing education, diversification, and increasing capacity of the maternal health workforce.
Apply continuous process improvement strategies for maternal mortality review protocols to support and increase case review capacity, quality, and recommendation development.