Maternal Morbidity and Mortality in the U.S.

What is the headline saying or claiming?
Link to article Severe Complications for Women During Childbirth Are Skyrocketing – And Could Often Be Prevented

What is the news article saying?
“The rate of life-threatening complications for new mothers in the U.S. has more than doubled in two decades due to pre-existing conditions, medical errors and unequal access to care. The U.S. has the highest rate of maternal mortality in the industrialized world.”

Does the headline ultimately support claims made by the news article? Does it truly summarize the key points of the news article?
Yes. The headline supports claims made by and summarizes the key points of the article.

What are the implications of this headline?
Despite living in a developed country, there are an increasing number of women in the U.S. who have severe complications during pregnancy that are preventable.

What are the implications of this news article?
Severe complications during pregnancy in the U.S., although preventable, are not rare and impact women from all walks of life.

Maternal mortality has not improved in the U.S. over the past few decades and is getting worse.

https://www.npr.org/2017/05/12/528098789/u-s-has-the-worst-rate-of-maternal-deathsin-the-developed-world

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31470-2.pdf

What evidence currently exists to counter or support these implications?
Severe maternal morbidity (SMM) is increasing, however, the causes are unclear and may be related to changes in the population of women giving birth in the U.S. This may inevitably place women at higher risk for complications.

https://www.cdc.gov/reproductivehealth/maternalinfanthealth/severematernalmorbidity.html

The article linked to the claim that the U.S. has the worst maternal mortality in the industrialized world also shares that the U.S. has improved its surveillance to identify more potential cases (whereas some of the countries it is being compared to have not).

The U.S. captures deaths occurring within 1 year of the end of pregnancy. This is different from other countries that only capture those which are within 42 days postpartum.

https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html

https://www.cdc.gov/cdcgrandrounds/archives/2017/november2017.html

According to the CDC’s most recent public health rounds on maternal mortality and morbidity surveillance, maternal mortality within 42 days postpartum has remained relatively flat over the past few years. Data collected between 1987 and 2013 also shows that there was a decrease in maternal deaths due to hemorrhaging and hypertension as well as an increase in maternal deaths due to heart conditions. These data indicate that there have been improvements in maternal mortality related to previously identified factors. Different factors are the cause of more recent increases in maternal mortality.

https://www.cdc.gov/cdcgrandrounds/archives/2017/november2017.html

Are there similar and/or opposing headlines from other news outlets? Do the news outlets only link back to other news outlets?
Similar articles link back to ProPublica/NPR.

What are the data sources (i.e. memo, official statement, official document, research study,  validated surveillance system, official report, etc.) supporting the article?


Are these data sources credible when applied to the news story? Why or why not?
These are credible sources because they are based on data that is available. However, the sources do not necessarily support the claims made in the article.

What are the data sources saying? Are they being interpreted correctly in the article and are limitations provided? Are there multiple ways to interpret the data or various conclusions that may been drawn from the data?
There are limitations that are not discussed in the article, especially for maternal mortality comparisons. However, the coverage for SMM seems to be relatively accurate.

 

What does this mean for the general public?
Those who are pregnant or trying to become pregnant (as well as their providers) should 
know that there is a risk for complications during pregnancy and their specific risk factors for complications during pregnancy. Patients and providers should also identify best practices to prevent complications during pregnancy before, during, and after pregnancy.

 

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Scrutinizer Product

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The Scrutinizer Challenge Initiative: A Charge for Epidemiologists and Partners

Watch my introduction video!

Scrutinizer Challenge Video

It can be difficult to distinguish between truth, fiction, half-truth, and misinformation as we watch the news, read headlines, and scroll through various social media feeds. Fortunately, epidemiologists have the tools needed to serve as a practical resource for colleagues, partners, and communities in these situations. The Scrutinizer Challenge initiative is an opportunity for epidemiologists to tackle at least one headline or news story a month that is relevant to public health. The goal is for all of us to understand how we can serve as a practical resource by doing the research needed to examine data sources and implications of news stories and research articles. This process can help us deliver consistent and reliable messages to share with colleagues, partners, and communities. It also provides an opportunity for public health practitioners to consolidate resources and develop working relationships between practice and academia.

The outline below provides guidance on how to approach The Scrutinizer Challenge initiative after identifying a headline/news story or research article of interest:

SC Guidance

 

Maternal Mortality Considerations

Scrutinizer Challenge initiative end products include a list of sources and a short explanation about how each source truly contributes to a research article/news story and its implications, as well as one of the following: 1) an actionable summary that could be shared with colleagues or 2) a summary that could be shared with a local partner/the general public.

Pathways for Utilizing the Scrutinizer Challenge


Scrutinizer Challenge initiative end products should be emailed to sophia.anyatonwu@gmail.com. Submissions may be highlighted in public health newslettters, as a separate report, or used as content in a round table discussion.

Join the movement, join the network #IAmAnEpidemiologist #EpidemiologyScrutinizer

Sophia Anyatonwu, MPH, CPH, CIC
sophia.anyatonwu@gmail.com
about.me/sanyatonwu