Maternal death rate soars in South Carolina

Nurses monitor infants in the Neonatal Intensive Care Unit in 2014 at McLeod Regional Medical Center in Florence.

Childbirth-related problems are taking the lives of South Carolina mothers at the highest rates since the turn of the century, even as the state has cut its infant mortality rate to the lowest ever.

Experts remain uncertain why pregnancy-related deaths of mothers have grown so high over the past few years.

They suspect it is due in part to growing numbers of women who go through pregnancy and childbirth while suffering from chronic diseases, such as diabetes and hypertension.

That, in turn, could be the result of the state’s high rate of obesity, which burdens one out of every three people. Among other ailments, obesity can cause diabetes and heart conditions.

Medical experts also suspect the increased rate of maternal deaths may be linked to inadequate access to health care, especially among poor rural and urban blacks.

A recent study by state health officials shows that black women die in pregnancy-related deaths at more then double the rate of whites.

Better reporting and records collection could also be a factor in the increased rates of maternal death.

The actual number of deaths due to pregnancy and childbirth complications are not large, averaging about 18 a year since 2007, when the rate began to spike, a state health department database shows.

During the five years prior to that, the state averaged just 5.6 such deaths.

South Carolina is not alone.

The state’s nearly 300 percent leap in the number of maternal deaths over the past few years looks even worse when compared to the nation as a whole.

The easiest way to compare the state to the nation is to look at the rate of mother deaths per 100,000 births.

The nation’s rate of maternal deaths also has been going up. In fact, it’s been on a steady climb since 1987 when it was 7.2 per 100,000 live births.

By 2013, that rate had more than doubled to an estimated 18.5 deaths for every 100,000 births, according to a study published last year in The Lancet medical journal.

South Carolina does even worse. Its maternal death rate has averaged about 25 per 100,000 births, according to a state health department analysis of the years 2007 through 2010.

The Lancet study also revealed that the U.S. is one of only eight countries to see a rise in these deaths over the last decade.

Among those countries are war-ravaged Afghanistan and South Sudan.

Discovering the reason for South Carolina’s skyrocketing rate of maternal deaths soon may be within reach.

This fall, physicians from the Medical University of South Carolina and the University of South Carolina will organize a maternal fatality review committee to take a deep look at every death of a mother linked to pregnancy and childbirth.

Scott Sullivan, director of Maternal-Fetal Medicine at MUSC, said he has been working with others for years to get state authorization for such a team.

He co-authored a bill to establish the committee. The bill was introduced to the Legislature this year by Rep. Murrell Smith (R-Sumter), whose father and brother are ob/gyns. It passed the House and made it to the Senate but didn’t get out of committee during the crush of last-minute business before lawmakers adjourned until January.

In the meantime, Smith managed to get temporary authorization for the committee through a budget proviso. It allows a multi-disciplinary review committee to organize and begin operation for up to a year until the bill passes.

Smith said he expects it to pass during next year’s legislative session.

The proviso authorizes the state health department to give details of pregnancy-related deaths to the panel and provides for confidentiality of records and legal immunity to the panel and those who provide it with medical records.

The proviso says the purpose of the committee is to review the fatalities and “develop strategies for the prevention of maternal deaths.”

Judy Burgis, chairwoman of the USC School of Medicine Department of Obstetrics, co-authored the bill with Sullivan and is slated to be the review committee’s chairwoman. Sullivan is the tentative vice chair.

Burgis said numerous factors could be at play in the increasing number of maternal deaths and lives could be saved if the cause or causes were pinpointed.

Now, she said, “We’re going to be able to get started and help moms and babies in our state.”

Reach Doug Pardue at 937-5558.