Many initiatives underway to curb maternal mortality
We, too, are disturbed by the dreadful maternal mortality rate in the United States. A Sept. 10 letter raises some interesting points to address how obstetric care providers can help lower the maternal mortality rate. Many of us who practice obstetrics do discourage women from elective induction of labor. Women should be informed of the potential risks of induction and encouraged to make an informed choice based on their needs and desires for their pregnancies.
The primary cesarean section rate at Women and Children’s Hospital of Buffalo is only 17 percent, lower than recent targets set by HealthyPeople.gov (23.9 percent), and the lowest in the region. This is noteworthy given the high-risk nature of our patient population in the Regional Perinatal Center of Western New York, where we deliver the sickest moms and the most premature babies. In addition, high malpractice costs and fear of litigation are not present in countries such as Canada.
The letter also didn’t address the many initiatives that have been adopted by us and others across New York State and nationally to address the rise in maternal mortality, including the Safe Motherhood Initiative established by District II of the American Congress of Obstetricians and Gynecologists. This initiative sets evidenced-based guidelines for the prevention and management of postpartum hemorrhage, severe hypertension and venous thromboembolism in pregnancy. We conduct drills to learn preparedness for obstetrical emergency situations and have adopted best-practice methods for prevention of surgical site infection following cesarean section and hysterectomy.
Rising rates of obesity, diabetes and hypertension are contributing to poorer maternal outcomes, but to say that we in the obstetrics and gynecology community are not cognizant of the roles we can play in promoting good outcomes by our awareness and management of these issues is a fallacy.
Vanessa M. Barnabei, M.D., Ph.D.
Professor and Chair, Department of Obstetrics and Gynecology, Jacobs School of Medicine and Biomedical Sciences
Gil Farkash, M.D.
Chief of Service for Women’s Services, Kaleida Health
Taechin Yu, M.D.
Associate Professor, Department of Obstetrics and Gynecology, Jacobs School of Medicine and Biomedical Sciences