It will take all of medicine to reduce maternal mortality

Sustainable Development Goals and Maternal Morbidity and Mortality in the U.S.

Maternal morbidity and mortality rates in the U.S. continue to be alarmingly high, despite being preventable. The top causes of maternal mortality include mental health conditions, anemia, cardiac disease, and hypertension, with over 80% of these deaths being preventable. To address this issue, collaboration and expertise from various physician specialties are urgently needed.

According to Dr. Kavita Shah Arora, an ob-gyn from Chapel Hill, North Carolina, “If we’re going to make a dent in maternal morbidity and mortality, it’s going to take the entire house of medicine.” Dr. Arora emphasized the need for ob-gyns to expand their knowledge and collaborate with other specialties to provide better prenatal, pregnancy, and postpartum care.

Addressing Maternal Morbidity and Mortality

During an education session at the 2024 AMA Annual Meeting in Chicago, panelists discussed how physicians from various specialties can address maternal morbidity and mortality. The following strategies were highlighted:

1. Address preeclampsia risk

   Dr. Nicole Lee Plenty, a maternal-fetal medicine physician in Atlanta, Georgia, emphasized the importance of identifying patients at risk for preeclampsia and prescribing low-dose aspirin. This preventive measure can significantly reduce the risk of preeclampsia, which can lead to bleeding and hemorrhaging. Timeliness in prevention is crucial for reducing the incidence of preeclampsia and death related to hypertensive disorders of pregnancy.

2. Measure blood pressure and act on it

   High blood pressure in pregnant patients should not be dismissed as anxiety. Dr. Plenty stressed the need to regularly monitor blood pressure to ensure early detection of preeclampsia. Counting blood pressure at every visit can prevent complications and save lives. The Target: BP initiative, co-led by the AMA and American Heart Association, provides resources and tools to help healthcare organizations improve and sustain blood pressure control.

3. Screen for perinatal mental health

   Mental health is a major concern in maternal health. Dr. Theresa Rohr-Kirchgraber, an internist from Athens, Georgia, highlighted the importance of screening for anxiety and depression. The Women’s Preventive Services Initiative is a valuable resource for patients and physicians. Training and education are essential in providing excellent care for perinatal psychiatric disorders. The American College of Obstetricians and Gynecologists’ perinatal mental health toolkit is recommended for healthcare professionals.

Efforts to improve maternal health and reduce morbidity and mortality rates require a collaborative approach across specialties. By addressing preeclampsia risk, monitoring blood pressure, and screening for perinatal mental health, healthcare professionals can make significant progress in achieving the Sustainable Development Goals related to maternal health.

Learn more about the AMA’s advocacy to improve maternal health.

SDGs, Targets, and Indicators

1. Which SDGs are addressed or connected to the issues highlighted in the article?

SDG 3: Good Health and Well-being

The article addresses the issue of maternal morbidity and mortality rates in the U.S., which is a key aspect of SDG 3. The high rates of preventable maternal deaths highlight the need to improve maternal health and well-being.

SDG 5: Gender Equality

The article emphasizes the importance of providing better prenatal, pregnancy, and postpartum care, which is essential for achieving gender equality. Access to sexual and reproductive health services and rights is crucial for ensuring the well-being of pregnant individuals.

SDG 17: Partnerships for the Goals

The article emphasizes the need for collaboration and expertise sharing across various physician specialties to address maternal morbidity and mortality. This aligns with SDG 17, which promotes partnerships for achieving sustainable development goals.

2. What specific targets under those SDGs can be identified based on the article’s content?

Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

The article highlights the need to lower maternal morbidity and mortality rates, which aligns with this target. The focus on preventing and addressing mental health conditions, anemia, cardiac disease, and hypertension as the top causes of maternal mortality contributes to achieving this target.

Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights

The article emphasizes the importance of providing better prenatal, pregnancy, and postpartum care, which is essential for ensuring universal access to sexual and reproductive health. Screening for perinatal mental health is also mentioned, which contributes to achieving this target.

Target 17.17: Encourage and promote effective public, public-private, and civil society partnerships

The article highlights the need for collaboration and expertise sharing across various physician specialties to address maternal morbidity and mortality. This aligns with the target of promoting effective partnerships for sustainable development.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article mentions or implies several indicators that can be used to measure progress towards the identified targets:

• Maternal morbidity and mortality rates in the U.S.
• Causes of maternal mortality: mental health conditions, anemia, cardiac disease, and hypertension
• Percentage of preventable maternal deaths
• Availability and accessibility of prenatal, pregnancy, and postpartum care
• Screening for perinatal mental health
• Collaboration across various physician specialties
• Expertise sharing and learning from each other’s expertise

4. SDGs, Targets, and Indicators

Source: ama-assn.org