Why Maternal Mortality Rates Were so High in Texas
As it turns out, the number of women in Texas who died from pregnancy complications in 2012 has been cut by more than half through a new method for counting and confirming maternal deaths. The previous method made the maternal mortality rate of Texas and quite a few other states the subject of national news coverage.
The study said the state’s data on maternal deaths of women 35 and older contained reporting errors, such as including women who had not been pregnant. By applying the new counting method, the number of Texas women who died from pregnancy complications that year dropped from 147 to 56.
“What we’re finding is that [the maternity mortality reporting form box] is often checked in error, just like any other checkbox on a big form,” said Elliott Main, medical director of the California Maternal Quality Care Collaborative, which reviewed the data in his state. “Because pregnancy-related deaths are so uncommon, the frequency of the box being checked in error can significantly impact the maternal mortality rate previously reported,” he added.
Texas’ adjusted 2012 overall maternal mortality rate was corrected from 38.4 deaths per 100,000 live births to 14.6. And the adjusted rate showed that black women in Texas still run the highest risk of dying during or after their pregnancy. It found the rate at which black mothers died during or soon after pregnancy was 27.8 per 100,000 live births, compared to 13.6 for white women and 11.5 for Hispanics.
Even the adjusted national numbers published in the Lancet and ProPublica (which reported a U.S. maternal mortality rate of 26.4 for every 100,000 live births in 2015) are still viewed as excessive. The American maternity mortality rate dramatically eclipses the rates of Great Britain (9.2), Australia (5.5), and Finland (3.8) per 100,000 live births.
Does This Simple Reporting Mistake Suggest Bigger Problems with Overall Medical Errors?
It wouldn’t be difficult to infer such a hypothesis, especially after a 2016 Johns Hopkins Medicine study concluded that medical errors should rank as the 3rd leading cause of death in the United States. The research also amplifies how shortcomings in tracking vital statistics and filling out normal forms (such as mistakenly checking boxes) could hinder research and keep the problem away from the public eye.
The Johns Hopkins study estimates that more than 250,000 Americans die each year from medical errors. On the list of mortality causes published by the Centers for Disease Control and Prevention (CDC), this would fall just behind heart disease and cancer as a cause of death. Both cancer and heart disease killed approximately 600,000 people in 2014. Medical mistakes that can lead to death range from unrecognized surgical complications to prescription and dosage errors.
The fact is no one knows the exact toll of medical errors. That’s due primarily to the coding system used by CDC to record death certificate data. It doesn’t account for things like communication breakdowns, diagnostic errors, and poor judgment that cost lives, said the head of research, Johns Hopkins surgeon Dr. Martin Makar, in his cover letter for the report sent to the CDC.