A bill that would establish a committee to review and prepare recommendations to prevent maternal deaths will head to the desk of Gov. Steve Sisolak after receiving unanimous approval from the Senate on Tuesday.
The panel — which will consist of between six and 12 members involved in health care, women’s issues, law enforcement, public health or maternal welfare — will be responsible for annually reviewing both maternal deaths and cases where pregnancy- and childbirth-related complications resulted in a physical or mental illness or disability, known as maternal morbidity. Following the review, the committee will be tasked with compiling a report to be released to the public and forwarding recommendations to the Legislature.
Passage of the legislation, AB169, comes amid growing concerns over the recent rise of maternal mortality. Pregnancy-related deaths have doubled in the U.S. over the last 25 years, with a roughly 700 women dying of pregnancy-related causes each year and another 65,000 suffering serious health complications, and the country has the highest rate of maternal deaths of any developed nation.
“We have, frankly, just too many women we're losing to childbirth, and that is true in the state of Nevada, and it's true across the nation,” Democratic state Sen. Julia Ratti said, presenting the bill on the Senate floor on Tuesday. “This is an effort to put together a qualified group of individuals to make sure that we understand what's going on.”
Maternal mortality also disproportionately affects women of color. According to the Centers for Disease Control and Prevention, black women face a significantly higher risk of maternal mortality, with 44 deaths per 100,000 births, than do white women, who only face 13 deaths per 100,000 births.
During a hearing last month, Assemblywoman Daniele Monroe-Moreno shared her own experience with maternal morbidity, which included falling extremely ill during her third pregnancy after miscarrying between each of her prior pregnancies. But when she asked her doctor to tie her tubes, he said no.
“My doctor at the time explained to me that I was too young to make that decision. All I wanted was my tubes cut and tied so that I could raise the three children that I had and not have to go through the experience of losing another one,” Monroe-Moreno said. “Oftentimes women, and women of color, our voices don’t matter as much … I would’ve been a person who would’ve been a part of this study.”
And though Nevada actually fares well in terms of maternal mortality deaths — with the third lowest rate behind only California and Massachusetts at 6.2 deaths per 100,000 — no one wants to see that number go up.
“Fortunately, Nevada is not at the top of that list, thank God, and I don’t want us to get there” Monroe-Moreno said in a brief interview Tuesday. “This is a way to do that.”
The Senate’s Tuesday vote comes a little bit more than a week before a deadline for states to apply for a slice of roughly $43.5 million in grant funds through the Centers for Disease Control and Prevention to investigate the causes of pregnancy-related deaths and complications. The funding was approved in the Preventing Maternal Deaths Act passed by Congress late last year.
Thirty-eight states have active maternal mortality review committees, and five more states and the District of Columbia have recently approved them.
Catherine O’Mara, executive director of the Nevada State Medical Association, said she believes Nevada has a “good shot” at the grant funding, in part because the commission won’t be very expensive to operate. The board members will be unpaid volunteers who will only receive daily per diem and travel expenses for their work.
She said that Sisolak, who called for the creation of a maternal mortality panel as part of his health-care platform during his gubernatorial campaign last year, has been “extremely supportive” of the legislation and that the state has been gearing up to submit its application as soon as he signs the measure into law. She noted that while the committee is tasked with recommending legislative solutions, the answer may be coming up with best practices for doctors, hospitals and birthing centers.
“For us it's about getting information so that we can take care of our patients better,” O’Mara said. “I think we're all really concerned about the disproportionate impact on black and minority women and trying to figure out what is happening there.”