Reducing Maternal Mortality in the United States through Collaboration

Healthy childbirth requires education and action prior to conception and should continue throughout the gestation period to monitor for any changes that require immediate medical attention. Approximately 60% of maternal deaths are preventable and family planning has shown to decrease the number of maternal deaths related to pregnancy.^1,2 Addressing the heightened rates in the United States requires the collaboration of medical expertise to maximize the health of mothers and their offspring.

California is one of the first states to take an initiative in the common complications that arise during childbirth. The California Maternal Quality Care Collaborative (CMQCC) has backed initiatives surrounding two common complications in childbirth: hemorrhaging and blood pressure. Since early prevention of these two serves as a crucial factor in the mother’s health, the team has created standard procedures through practicing these events through simulation, formulating a method for the measurement of blood loss, and creating an accessible toolkit to treat such events when they arise. The Pomona Valley Hospital Medical Center is laying the foundation for protocols that will save a woman’s life during childbirth. Utilizing this expertise has shown benefit based on efforts by the CMQCC and can further be supported by preventative care measures employed by the pharmacist.³

The Pharmacist’s Role in Reducing Maternal Mortality

The pharmacist’s scope of practice can have a significant impact on the rates of maternal mortality in the United States, ranging from preconception care, interventions during pregnancy, and patient education.² The relationship between unintended pregnancies and maternal mortality suggests that reducing rates of unintended pregnancy would be beneficial in, too, reducing rates of maternal mortality. Pharmacists could also aid in the development of a reproductive life plan (RLP) with patients to firstly aid in pregnancy planning. RLPs involve both partners and “includes goals patients make personally about having or not having children and encourages intentional pregnancy planning.”⁴ Initiating a conversation about a RLP also serves as an opportunity to address a patient’s health needs. For people who are looking to prevent pregnancy, a pharmacist can aid a patient in choosing a contraceptive method that suits the patient’s lifestyle and preferences. For those who do have intentions to become pregnant in the near future, pharmacists can provide education and counseling on health behaviors that could be harmful to a potential pregnancy.⁴

The Significance of Collaboration

The role of the pharmacist is continually evolving. In collaboration with other healthcare professionals, pharmacists can lay the groundwork needed to reduce maternal morbidity in the United States. Pregnancy planning and education could allow for the formation of RLPs and reduce the number of unintended pregnancies as well as increase awareness for behaviors that could hinder or advance maternal-infant outcomes. Pharmacists’ intervention in conjunction with the initiatives such as the CMQCC could provide for significant breakthroughs in health and wellness before, during, and after parturition.

References

1. “Maternal Mortality.” Centers for Disease Control and Prevention, 13 Aug 2020. Available at: www.cdc.gov/reproductivehealth/maternal-mortality/index.html.
2. Tsui AO, McDonald-Mosley R, Burke A. Family Planning and the Burden of Unintended Pregnancies. Epidemiologic Reviews. 2010;32(1):152-174.
3. Montagne, Renee. “To Keep Women from Dying in Childbirth, Look to California.” NPR, 29 July 2018. Available at: https://www.npr.org/2018/07/29/632702896/to-keep-women-from-dying-in-childbirth-look-to-california.
4. Peters LM, DiPietro Mager NA. Pharmacists’ Provision of Contraception: Established and Emerging Roles. Innov Pharm. 2016;7(3):15.

About the Author

Courtney Smith, PharmD Candidate is a pharmacy student in the Class of 2024 at Ohio Northern University.

Reviewed by Natalie DiPietro Mager, PharmD, PhD, MPH.