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Strengthen the Evidence for Maternal and Child Health Programs

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Woo M, Glover A. 2021. Severe maternal morbidity in Montana: Near-miss obstetric events in a rural state. Missoula, MT: University of Montana Rural Institute for Inclusive Communities and the Montana Hospital Association,

Annotation: This report presents an analysis of severe maternal morbidity (SMM) among Montana residents who delivered in Montana hospitals from 2016-2018, using hospital discharge data. SMM refers to life-threatening obstetric complications that lead to significant short-term or long-term consequences. The report uses the CDC's ICD-10 based definition to identify SMM cases and rates. Key findings include: an overall SMM rate of 110.5 per 10,000 delivery hospitalizations; blood transfusion as the most common SMM indicator followed by hysterectomy and acute renal failure; and increased risk of SMM associated with Medicaid coverage, younger (<20 years) and older (≥35 years) age, residence in very rural counties, and American Indian/Alaska Native race. In particular, American Indian/Alaska Native individuals had triple the risk of SMM compared to white individuals, and those in the most rural counties had nearly double the risk compared to those in small metropolitan counties. The report discusses the intersecting racial and geographic disparities and provides recommendations to alleviate SMM through focused, culturally-sensitive, rurally-tailored care and prevention efforts in partnership with impacted communities. It also examines SMM in the context of severe hypertension and hemorrhage to inform state maternal safety initiatives.

Keywords: Data, Maternal morbidity, Montana, Obstetric labor complications, Rural health, State initiatives
   

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