Commission pledge action to reverse rising rate of maternal fatalities

Published on April 13, 2023

Prompted by an alarming rise in the number of post-partum deaths, and large gaps in the maternal care available to women of color, the Wayne County Commission has pledged local action to reverse that nationwide trend.

"We are all working together to address this rise in Wayne County," commission Chair Alisha Bell (D-Detroit) said, noting the commission, county executive's staff and county medical director are working together to reduce the number of birth-related fatalities. Commissioners on April 11 adopted a resolution recognizing, "the need for further investments communitywide in maternal health, addressing systemic racism within medical care and creating avenues for accessible mental health and substance use disorder treatments." The resolution notes that rates in the U.S. grew from 20.1 deaths per 100,000 pregnancies in 2019 to 32.9 in 2021, an increase of roughly 60 percent.

It also notes that the rate for Black women in 2021 was 69.9 deaths for every 100,000 pregnancies.

The resolution grew from discussions held by the Wayne County Women's Commission, formed by Chair Bell two years ago to address and advocate for issues of concern for women living in the state's largest county.

"This is a major problem, not only nationally, but here in Wayne County," said Commissioner Melissa Daub (D-Canton Township) who serves on the women's commission. Maternal death is defined as the death of women while pregnant or within 42 days after the end of pregnancy.

A copy of the resolution follows:

RESOLUTION
By Commissioners Bell and Daub

WHEREAS, a maternal death is defined by the World Health Organization 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 aggravated by the pregnancy or its management, but not from accidental or incidental causes;" and

WHEREAS, in 2021, the death rate per 100,000 live births for women under 25 was 20.4, for women between the ages of 25 to 39 the death rate was 31.3, and for those who were 40 and older, the death rate was 138.5; and

WHEREAS, new federal data has shown the COVID-19 Pandemic compounded the ongoing US maternal mortality crisis, and led to a dramatic increase in deaths overall, to 32.9 deaths per 100,000 live births in 2021, compared to 20.1 deaths in 2019; and

WHEREAS, according to the most recent global comparison data kept by the World Bank, the maternal mortality rate was twice as high in the United States than in the United Kingdom, Germany and France, and three times higher than in Spain, Italy, Japan and several other countries; and

WHEREAS, the Centers for Disease Control and Prevention confirms these findings and the increase to be 40 percent compared to before the pandemic began, and the rate for Black women in 2021 was more than double when compared to their white counterparts, at a rate of 69.9 deaths per 100,000 live births; and

WHEREAS, these health risks disproportionally affect Black, indigenous and all people of color due to structural, systemic and environmental factors; and

WHEREAS, a recent report from National Academies of Science, Engineering, and Medicine (NASEM) found within the Journal of Women's Health online has identified five essential activities that have been found beneficial for the integration of social needs into health care, which are: awareness, adjustment, assistance, alignment and advocacy; and

WHEREAS, awareness indicates the need for screening for social determinants of health and adjustment addresses the need of tailoring services to resolve the negative determinants and support the positive. Assistance and alignment both speak to strengthening social supports and redesigning health services to meet the needs of the public. Finally, advocacy includes making use of local, state and federal governments to support public health efforts in addressing the social determinants of health consistent with clinical care within the context of the communities where care is provided; and

WHEREAS, these steps not only help us understand the social aspects of how resources are distributed, but also help us identify strengths or weaknesses within cultural norms, policies, institutions and practices, also known as structural determinants of health; and

WHEREAS, Wayne County recognizes the need for further investments communitywide in maternal health, addressing systemic racism within medical care and creating avenues for accessible mental health and substance use disorder treatments;

Now therefore be it

RESOLVED, by the Wayne County Commission on this 11th day of April, 2023 dedicates the week of April 11-17 as Black Maternal Health Week within the County, to improve public and professional awareness of the issues related to maternal health and mortality, as well as show support of state and federal initiatives to improve maternal health throughout the County, State and Country.

Commission pledge action to reverse rising rate of maternal fatalities(PDF, 203KB)