030819 Touro child birth complications

Louisiana’s mothers and their supporters may have felt disturbed or afraid after reading last week’s articles about birth care in New Orleans.

Hardworking providers — physicians, nurses, and midwives — may have felt misunderstood or painfully reminded of a case that went poorly.

Medical trainees, Louisiana’s future birth providers, may have felt deterred from their calling.

And undoubtedly all of us felt deep sorrow at stories of suffering and families changed forever, leaving us asking, “what can we do to stop this?”

No single institution or individual can change the reality of Louisiana’s worsening maternal health crisis. We rank 47th of 48 reporting states in maternal mortality. Black women are four times more likely to die of complications of pregnancy when compared to white women, due to lifetimes of differences in care, education, healthy environments, accumulated stress due to racism — or simply being less likely to be heard during a critical moment.

It does not have to be this way. Not every instance of severe maternal morbidity is avoidable, but harm from bleeding and high blood pressure, Louisiana’s leading causes of pregnancy-related death, is preventable. Solutions exist: doctors, nurses, patients, and leaders, working together to improve communication, preparedness, response time, teamwork, and escalation of care when needed.

Childbirth is typically normal. Our numbers reflect system failures in preparedness for rare events — not the choices of individual women or providers. Systems solutions have worked in other states, countries, and some hospitals here in Louisiana.

In fact, every New Orleans hospital named in last week’s article is already participating in the Louisiana Perinatal Quality Collaborative. This 31-hospital collaborative is using shared accountability and coaching from experts to make change. Our goal is to reduce severe maternal harm due to bleeding and blood pressure in Louisiana by 20 percent, and reduce differences between black and white women — in one year.

To do this, we need to translate frustration and concern into immediate action:

If you have experienced birth in a Louisiana hospital and have ideas for what could have gone better, we want to hear your ideas, and invite you to work directly with a collaborative team in your community.

If you are a provider at a Louisiana birth facility, find out if your facility is participating, and what you can do to help your team today.

If you are a hospital executive or legislator, ensure that your collaborative teams have the support they need to make change that matters to families. Demand that hospitals in your region partner with each other to take the best care of the sickest among us.

Let’s use our discomfort to achieve equitable, consistent care for every woman, every time. And let’s do it together, now.

Dr. Pooja Mehta

medical director, Louisiana Perinatal Quality Collaborative

Baton Rouge