One in 10 Georgians know of someone who has died during pregnancy, at delivery, or soon after giving birth.
That’s the major finding in a new survey released Wednesday at a first-of-its-kind Emory University conference on maternal mortality. Among the top needs, speakers and attendees at the conference said, are better access to health care, and health insurance. Georgia has the third-worst uninsured rate in the nation, partly because it has not expanded Medicaid to all poor adults where 40 other states have.
Dr. Kathleen Toomey, commissioner of the state Department of Public Health, pointed out that the state recently expanded Medicaid for new moms from six months after giving birth to 12 months. “Is that enough?” she said. “I wish (that we had more). But hey, I’m going to take what we’ve got and we’re going to run with it.”
She and other speakers stressed that women who die in or after childbirth often needed treatment not just at that moment, but well beforehand to deal with underlying conditions.
“It’s more than just during and after pregnancy,” Toomey said. “We need to ensure they have care throughout their lifespan. How can we do that?”
Credit: Courtesy of Emory University
Credit: Courtesy of Emory University
Problems Toomey raised include transportation, since, she said, no matter how good care is it doesn’t help if the patient can’t reach it. She noted 17 hospitals in Georgia had closed in preceding years, including Atlanta Medical Center and 16 rural ones, all making care harder to get than it was already.
The programs the state does have are limited. That’s partly because DPH has successful programs that improve maternal care at rural hospitals but it can’t force hospitals to participate. Also, it depends on the Legislature for funding. It has piloted a home-visiting project for health workers to keep contact with new moms in 16 counties. “When I was asked by the governor’s office, ‘Do you have other counties that need it,’” she said, “I said, ‘Yes, throw a dart.’” The program will now be greatly expanded, she said.
Other improvements in Georgia that she cited include data. She noted the first maternal mortality review Georgia produced had five-year-old data. “We’re chasing our shadows,” she said. The latest one was more current.
The survey was conducted in October by Emory University’s Woodruff Health Sciences Center in collaboration with Research!America, a health research advocacy group. The results of the public opinion poll were unveiled Wednesday at the inaugural Symposium to Address the Maternal Health Crisis in Georgia, at Emory and also featured personal testimonies by individuals and families affected by maternal mortality.
Credit: Courtesy of Emory University
Credit: Courtesy of Emory University
Elsewhere in the Emory and Research!America survey of over 1,400 Georgians, nearly 60% of respondents noted that they have experienced or know someone who has experienced complications during pregnancy. More than a third of the people polled noted that racism is a major obstacle to achieving equal health outcomes.
Experts say the data serves as confirmation of the outsized toll that the maternal mortality crisis is taking on Georgia, where the rate of pregnancy-related deaths is among the nation’s worst, and where Black women face triple the odds of dying from pregnancy-related complications than white women.
Dr. Ravi I. Thadhani is the executive vice president for health affairs at Emory University. He says the results of the survey provide additional confirmation of the “widespread impact” of the maternal health crisis in Georgia, which he noted also changes the lives of women’s families and their children.
“The downstream effects are perverse.”
Survey participants from both sides of the political spectrum — 89% of Democrats and 74% of Republicans — agreed that it is important for elected officials to support efforts to reduce maternal mortality.
“It’s an issue that affects every individual in this state, and especially pregnant women,” Thadhani said. “And as a result, we need to come together as a state to address this crisis.”
Heart and blood problems top the list of Georgia killers of new moms. In all, the leading cause of maternal deaths in Georgia are hemorrhage; mental health conditions; cardiovascular or coronary conditions; embolism; and preeclampsia or eclampsia, according to a report released earlier this year examining deaths from years 2018 to 2020.
Respondents to the Emory and Research!America poll perceive substance use disorders (47%), lack of insurance (47%), and mental health challenges (41%) as the top factors likely to yield an increased risk of maternal mortality.
Health equity
When it comes to Black women’s heightened risk of pregnancy-related complications, the data is unequivocal, showing disparities in maternal-health rates that cut across all education and income levels. Instances of doctors, nurses or aides failing to take patients’ complaints — among the biggest lost opportunities to save a life — are especially harmful to Black patients, research suggests.
A Black woman in Georgia is more than twice as likely as a white woman to die of pregnancy, a disparity that cuts across income or education.
In the Georgia survey results published Wednesday, African Americans are 48% more likely to face a lack of available appointments. In addition, they are 23% more likely to run into issues securing transportation and 23% more likely to have to go to a hospital or a clinic that is too far from home.
Overall, 61% of the survey’s respondents said they think that the health care system treats people unfairly based on their ethnic or racial background. That same percentage also said people may be treated unfairly based on their level of English fluency.
Cost barriers to care
According to more than half (54%) of Georgians polled, the top barrier to health care is its high cost, even with insurance – something that only about 70% of respondents said they had.
Wednesday’s symposium was held in partnership between Emory University’s Woodruff Health Sciences Center, Research!America, Morehouse School of Medicine and the Mercer University School of Medicine, among other organizations in Georgia.
Findings of Research!America and Emory survey on Maternal Mortality:
- Many Georgians (57%) have experienced or know someone who has experienced complications during pregnancy and 10% know of someone who has died during pregnancy, at delivery, or soon after giving birth.
- Rural respondents are more likely (65%) to say they have been or know someone who has experienced complications during pregnancy.
- Respondents say racism is an obstacle to people achieving equal health outcomes. 36% say it is a major obstacle, 32% say minor obstacle, and only 23% say racism is not an obstacle.
- Georgians say that improving affordability of maternal health care (73%) and access to health insurance coverage (70%) are top priorities to reducing maternal mortality.
- Most Georgians (82%) across party lines (92% Democrats, 80% Republicans) say it is important for the state of Georgia to increase investment in initiatives to reduce maternal mortality.
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