Maternal Mortality and Digital Health

The United States has the highest rates of maternal mortality of high income countries, and higher rates than some lower income countries. Black women in America have twice the rates death compared to the average. And while most other countries, and all regions, have declining rates of maternal mortality, only the US has sustained increases over the past two decades. The number of women, particularly Black women, in the US who die within seven weeks of pregnancy termination is staggering, wholly preventable and an absolute stain on this country’s health system.

COVID certainly played a role in some maternal mortality. A study of available data concluded that mortality increased by 22% due to pregnancy-related causes from 2019 to 2020. Black women faced the highest increases of deaths due to all causes, the highest increases seen in homicides. Previously available global information showed that COVID interrupted service for pregnant people and children, having serious effects on their healthcare.

Some mitigations of the decline in access to treatment has been seen from digital technologies. Telehealth, for example, is one key way providers and patients can stay in touch. There are clear benefits to telehealth for prenatal and antenatal health, and HHS has a page of resources for telehealth/remote monitoring of patients with high risk pregnancies. (Of note, the page includes the option of at-home fetal monitors, which obviously provides benefits, particularly for devices that work well, but has downsides).

However, perhaps specifically to women of childbearing age, the Dobbs decision has already chilling effect on people seeking care (as well as some widely reported instances showing the denial of care), and will certainly affect access to remote care, including medication abortion.

And for those that don’t trust the medical or law-enforcement system (often  good reason), adding tools that may or may not work for them, and could be used against them, might not seem like a great idea.

If doctors can’t, or don’t, listen to women, do these additional data points provide hard evidence on which providers will act? Will these resources be available to pregnant people in remote or urban areas, or those without access to sufficient maternity/antenatal care? If there is a problem, particularly in today’s political climate, can women get the medical care they need?

We can’t tech our way out of the maternal mortality crisis, but well-tailored policies could help.