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How comprehensive data documentation holds the power to transform maternal mortality rates

Melissa Clarke, MD
Conditions
January 14, 2024
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The United States is a global medical care leader in many aspects, including the development of new pharmaceuticals, acute stroke care, and cancer screening. Yet, despite our advances and wealth, we lead peer nations in maternal mortality and morbidity.

While the vast majority of the nearly four million women who give birth in America every year do so without complications, maternal deaths have more than doubled over the past two decades.

In fact, for every maternal death, 70 more birthing individuals experience serious, sometimes life-threatening complications.

Even more shockingly, the Centers for Disease Control and Prevention (CDC) says more than eight out of 10 pregnancy-related deaths are preventable.

Let’s be very clear: Maternal mortality and morbidity are multifactorial and cannot be solved overnight. Large systematic issues are at play—in addition to deep racial and socioeconomic inequities. We must remain committed to tackling this issue from multiple angles.

I’m here to say I have hope. There is an incredibly powerful, readily available tool that I’m certain will make big leaps in helping us course-correct mortality rates: accurate and complete data documentation. So why is data documentation so critical to the maternal mortality and morbidity crisis?

It enables us to analyze and illuminate the factors that contribute to maternal deaths and comorbidities—bringing to light a clearer understanding of what we should pay attention to. We’re better equipped to identify root causes, take meaningful and actionable steps, and monitor our progress.

Accurate data documentation of not just clinical but also health-related social needs, race, ethnicity, language, sexual orientation, and gender identity data allows us to:

1. Proactively flag potential issues. If we can more accurately identify and document pregnant individuals’ symptoms or experiences, we can be more proactive in flagging potential issues that may lead to a worse outcome. For every maternal death, there are about 70 mothers who experience hemorrhages, organ failure, or other severe maternal morbidities. By better recognizing patterns, we can be proactive about decreasing the morbidities that may ultimately lead to a decrease in mortalities, too.

2. Identify disparities. Data documentation can illuminate unwanted disparities in care and outcomes. Armed with information, health care providers can focus efforts on reducing disparities and provide more equitable care.

3. Monitor progress and implement evidence-based solutions. Accurate and complete documentation allows us to track progress over time. By comparing risk-adjusted cohorts of patients and their outcomes, we have the capability to benchmark organizational efforts and compare them against similar organizations as well as federal benchmarks. In doing so, we can assess and share learnings. When implementing evidence-based solutions like pregnancy medical homes, telehealth monitoring, transportation benefits, or group pre-natal classes, we can more clearly assess the impact on our population.

4. Enhance accountability. Data documentation holds us all accountable – health care providers, organizations, and policymakers alike – to make or enact change.

In the push to decrease maternal morbidity and mortality, data documentation is both the key that will help us to unlock the solutions and the compass that will help guide us towards better outcomes for both moms and newborns.

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The U.S. maternal mortality crisis demands a comprehensive, data-driven approach. Data documentation is not only a formality but a critical tool that can help identify and address the root causes of maternal deaths, reduce disparities, and ultimately save more lives. To truly tackle this crisis, we must start with robust and standardized data documentation practices, enabling us to build a health care system that safeguards the well-being of every mother, regardless of race, socioeconomic status, or background. It’s time to embrace data documentation as an indispensable ally in the fight against maternal mortality.

Melissa Clarke is a physician executive.

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