Severe health problems after childbirth in Pa. rose 40% between 2016 and 2022

Pennsylvania is facing a worsening crisis of severe health problems after childbirth, according to a new state report that found a 40% rise in the rate of poor outcomes between 2016 and 2022.

The data released this week offers a chilling snapshot of a national maternal health crisis that disproportionately affects people of color and low-income families, even as more health resources were devoted to improving prenatal and postpartum care.

Both in Pennsylvania and nationally, Black people are more likely than white people to die during pregnancy or after childbirth, and to report higher rates of poor prenatal and postpartum care, according to recent reports from U.S. Centers for Disease Control and Prevention.

Across Pennsylvania, Philadelphia County had the fourth-highest rate of so-called maternal morbidity — long- and short-term health problems such as sepsis, blood clots and kidney failure — that may arise after giving birth, the Pennsylvania Health Care Cost Containment Council found in an analysis of the hospital billing data that it tracks.

Only Pike, Carbon and Lehigh Counties in the northeast part of the state experienced higher rates of such illnesses, according to the PHC4 report released Thursday.

Better understanding the health problems that people experience after giving birth — and the circumstances that contributed to them — could help clinicians and policymakers to keep patients safer, said Aasta Mehta, the medical officer of women’s health at the Philadelphia Department of Public Health.

Childbirth complications should also serve as a warning of systemic problems that, if unaddressed, could contribute to rising maternal deaths, she noted.

“You had a bad complication this time. Maybe next time you don’t survive,” said Mehta, a physician who oversees the city’s new surveillance system to track postpartum health problems, as well as a committee that reviews deaths in Philadelphia related to childbirth.

» READ MORE: New moms keep dying in the weeks after birth, and the risk remains highest among Black women

The state’s findings come as the CDC this month released a survey that found 1 in 5 mothers felt mistreated during their prenatal care.

Black, Hispanic and multiracial parents reported higher rates of verbal abuse, lack of respect for personal privacy and racial discrimination.

The number of Americans who die during pregnancy, childbirth or in the months following has been rising steadily. Most recently, the CDC reported a 38% jump in maternal mortality between 2020 and 2021, with 32.9 deaths reported per 100,000 live births. (The CDC defines maternal mortality as any death during pregnancy or within 42 days of the end of pregnancy.)

Among Black people, the rates were 2.6 times higher than among white people.

PHC4 similarly found higher rates of birth-related health problems among Black Pennsylvanians, as well as those in the state who receive health care through Medicaid, the publicly funded coverage for low-income individuals, or those living in low-income neighborhoods. People who were at least 40 years old when they gave birth were also more likely to experience serious unexpected health problems, according to the state report.

Overall, Philadelphia County saw 171.9 cases involving severe maternal health problems per 10,000 live births, compared to a statewide rate of 105.2 cases per 10,000 live births.

Philadelphia has launched a mandatory reporting program for hospitals that is intended to capture more detail about the health problems that occur after childbirth. Beginning in January, hospitals will report information about ICU admissions, blood transfusions, prolonged hospitalizations and readmissions among patients who recently gave birth.

Analyzing individual cases, and in some instances interviewing patients and doctors, will help the health department determine “what exactly happened,” whether the problems could have been prevented and identify systemic problems that need attention, Mehta said.

The new reporting system is one of several recent policy initiatives aimed at addressing a crisis of poor health outcomes after childbirth.

Last year, Pennsylvania extended Medicaid coverage to a full year after birth, up from 60 days postpartum, in an effort to bolster medical care during a vulnerable time.

About half of the pregnancy-associated deaths in Philadelphia between 2013 and 2018 occurred between six weeks and a year after birth — and in most cases after Medicaid coverage had ended, according to the most recent report from Philadelphia’s maternal mortality review committee.

Philadelphia was among the first municipalities in the country to create such a committee to track and review maternal deaths in 2010.

The latest state report’s findings show that “we have not done enough to protect women’s health in Pennsylvania,” said Rep. Morgan Cephas, a Philadelphia Democrat who has advocated for more reporting of severe maternal health problems, in a statement.

Reversing trends decades in the making will take time, Mehta said.

“Just talking about it is an inflection point,” she said, “but changing systems takes much longer than a couple of years.”