Georgia has ranked 48th, 49th, or 50th for maternal morbidity and mortality (MMM) nationally, with a maternal mortality rate reaching 72.1 deaths per 100,000 live births from 2018-2020, in contrast to the national rate of 29.6 (MMRC data).
Within Georgia, severe maternal morbidity and mortality (SMM) rates are significantly disparate based on social determinants of health with the highest rates among Black, publicly insured, or uninsured. Furthermore, according to the most recent Georgia Maternal Mortality Review (MMRC), 53% of maternal deaths are within 64 days postpartum, and 60% are due to maternal cardiac disease (cardiomyopathy, cardiovascular disease, pulmonary embolism, or preeclampsia).
Despite initiatives at both state and hospital levels, such as the establishment of MMRCs, the extension of Medicaid coverage for one year postpartum and implementing Alliance for Innovation on Maternal Health (AIM) bundles for maternal hypertension and hemorrhage, instances of pregnancy-associated and pregnancy-related deaths continue to rise.
In a departure from prior years, maternal mental health was identified as the second leading cause of maternal mortality between 2018-2020. One hundred percent of these deaths were deemed preventable. Data from the most recent MMRC showed that nearly 85% of all maternal deaths were deemed preventable. Tragically, patients who died often had signs and symptoms overlooked or not recognized by patients, families, and providers as indicators of severe disease.
Supporting efforts to reduce maternal mortality crosses partisan divides as these efforts are essential for protecting maternal health and ensuring access to care for all pregnant persons, regardless of political affiliation. Data from a recent statewide survey administered by Research!America noted that 80% of participants say they would support including funding for research and support investments for initiatives to reduce maternal mortality. Over half of the total participants in the survey report knowing someone who was affected by pregnancy complications. Furthermore, 67% of rural respondents reported knowing someone who had dealt with pregnancy complications, further highlighting the inequities that exist for a large population of the state.
Maternal mortality in the state of Georgia is a multifactorial issue and therefore demands a multidisciplinary approach. The closing of over 41 labor and delivery units since 1994 has not only created vast care deserts, but expanded how many communities are deemed, “rural”. There are 159 counties within the state of Georgia, and 82 counties do not have a single practicing obstetrician. An additional 15 counties only have one practicing obstetrician. These care deserts have also forced creative solutions to bridge the gap like remote monitoring services or support groups within rural communities.
Despite efforts in outreach, technology, resources, research and knowledge, Georgia continues to experience high rates of maternal morbidity and mortality. These deaths continue to increasingly affect women of color and those from underserved and rural communities. Furthermore, limited postpartum support increases the risks faced by new mothers, and sometimes lead to devastating consequences.
Addressing maternal mortality in Georgia requires a comprehensive approach and efforts must be made to combat this epidemic. It is imperative to work to ensure that every woman, regardless of race or socioeconomic status, receives the care and support necessary for a safe and healthy pregnancy, delivery, and postpartum period.
Dr. Lauren Holt
Dr. Holt is a second year resident physician in the Department of Gynecology and Obstetrics at Emory University. She has special interest in maternal mortality, and increasing access to care. She is originally from Tampa Florida, and a graduate of the University of South Florida, Morsani College of Medicine.
Dr. Jayne Morgan
Dr. Morgan is a cardiologist and the Executive Director of Health and Community Education at the Piedmont Healthcare Corporation. She has a focus on health equity including the recruitment of minority populations into clinical trials. With an interest in both menopause and cardiology, she is widely recognized as a pre-eminent Women’s Health expert. Dr. Morgan’s expertise encompasses the diagnosis and treatment of various cardiac conditions, including heart disease, arrhythmias and heart failure.
Dr. Jane Ellis
Dr. Ells is an Associate Professor and Eminent Professor at Emory. She practices at Grady Memorial Hospital and is the Obstetric Medical Director for the Emory Regional Perinatal Center at the Grady Health System. Dr. Ellis is a founding member of Georgia’s Maternal Mortality Review Committee and Perinatal Quality Collaborative. She is a member of a team leading a statewide initiative to improve access to cardiac care for pregnant and postpartum patients and outcomes for patients experiencing cardiac issues during pregnancy or in the postpartum period.
Dr. Suchitra Chandrasekaran
Dr. Chandrasekaran is an Associate Professor in Maternal Fetal Medicine at Emory University. She is a physician scientist with a research background in maternal cardiometabolic health and maternal morbidity and mortality. She leads a postpartum cardiometabolic clinic service line for persons who have experienced hypertension, diabetes or other cardiometabolic issues during their pregnancies.
