Maternal health problems in PA have spiked since 2016, report shows
- Severe maternal morbidity is increasing in Pennsylvania, with a 40% spike since 2016, disproportionately impacting Black women.
- Maternity deserts are expanding in rural Pennsylvania, with 38 hospitals closing labor and delivery units in the past two decades.
- Hospitals struggle to fill vacancies in essential maternity care roles, including nurse midwives, registered nurses and physicians.
Pennsylvania women are at increasing risk of suffering serious health problems during or after their pregnancies, with severe maternal morbidity spiking by 40% since 2016, according to a new report.
In addition, the commonwealth’s maternal healthcare systems are grappling with serious provider shortages and struggling to serve rural communities, according to an action plan released this month by the Hospital and Healthsystem Association of Pennsylvania (HAP).
The report documents the scope of these challenges but also offers recommendations that hospitals, HAP and policymakers can adopt to improve maternal health care.
Here are some of the report’s highlights:
More:Pregnant women in rural Pa. face expanding ‘maternity deserts.’ Here’s why.
Severe maternal health problems are on the rise
Serious maternal morbidity, or health problems during and after pregnancy, jumped significantly in the commonwealth from 2016 to 2022, reaching about 105 cases per 10,000 deliveries, according to the report.
HAP also noted the racial disparities in the commonwealth’s morbidity statistics, with Black women at 2.3 times the risk of white women.
More:Could visit to Erie’s Mercy Center for Women help the state craft a maternal health plan?
An increase in preexisting health issues, such as diabetes or high blood pressure, is contributing to this trend, according to HAP. Mental-health conditions and substance-use disorders also play a major role and are the top cause of pregnancy-related deaths.
To address this problem, the report indicates that
- hospitals can foster collaboration between doctors and mental-health professionals, use remote blood pressure monitoring and other tools to treat preexisting conditions and make sure they’re screening pregnant people for substance use disorders;
- HAP can make connections between hospitals, health departments and local community groups to ensure continuity of care. The group can also present data broken down by race and ethnicity so member hospitals can evaluate disparities in obstetric outcomes; and
- policymakers can require private insurers to cover doulas and can expand home visitation programs, which are now funded in just 19 of Pennsylvania’s 67 counties. They can also require insurance companies to cover blood pressure monitoring systems.
More:Pa. doulas can now register as Medicaid providers. Are there any near you?
Maternity deserts are growing
In the past two decades, 38 Pennsylvania hospitals have shut down their labor and delivery units. Eighteen of these hospitals were in rural communities, where patients often have to travel further to find alternative care.
Nearly half of women living in rural areas face a trip of 30 minutes or more from a hospital where they can give birth, according to the report. And six counties have so few services that they are classified as maternity deserts.
To address this problem, the report says
- hospitals can offer more telehealth options and try to weave maternity services into primary care, which might be more accessible to patients. They can also make sure their emergency rooms are prepared to handle childbirth;
- HAP can facilitate conversations between healthcare providers across Pennsylvania about closing gaps in care. They can also help emergency rooms carry out readiness drills to prepare for obstetric cases; and
- policymakers can review Medicaid reimbursement rates for obstetric care and support the expansion of behavioral health care for pregnant women. They can also avoid passing legal mandates that prevent hospitals from finding innovative solutions to rural care needs.
Many hospitals are struggling to fill vacancies
Nearly a fifth of nurse midwife positions and certified registered nurse practitioner positions are vacant in Pennsylvania hospitals, according to the report. The problem is even worse in rural communities, where about 28% of nursing support staff roles and more than a quarter of registered nurse positions are unfilled, the document states.
More:Erie hospitals have staffing shortages. How are they recruiting potential workers?
Adding to that, a survey recently conducted by HAP found that obstetrics and gynecology was one of the specialties most in need of more physicians.
To address this problem, the report says
- hospitals can offer scholarship or loan forgiveness programs for people who want to enter the field and recruit from underrepresented communities;
- HAP can host a summit where health providers can share ideas and continue collecting data on workforce needs; and
- policymakers can take action to control medical liability claims that have driven provider insurance premiums upward.
Bethany Rodgers is a USA TODAY Network Pennsylvania capital bureau investigative journalist.
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