Jefferson’s Midwifery Institute Director Dana Perlman, CNM, DNP, FACNM, serves as legislative chair of the Pennsylvania affiliate of the American College of Nurse-Midwives (ACNM), a key organization that pushed for legislation to address maternal mortality in Pennsylvania. On May 9, Governor Tom Wolf signed into law House Bill 1869, which will create a 15-member Maternal Mortality Review Committee in the Department of Health to collect confidential information or investigate and disseminate findings related to maternal deaths.
Prior to this legislation, no mechanism existed for collecting this important data, which can lead to systemic changes needed to decrease maternal mortality. Maternal deaths have been rising in the United States since 2000, while they have decreased in nearly every other country in the world, according to the Centers for Disease Control and Prevention. The rate has more than doubled in Pennsylvania since 1994.
The Pennsylvania Section of the American College of Obstetricians and Gynecologists (ACOG) successfully crafted this bill and got it introduced, Perlman said. The Pennsylvania affiliate of ACNM worked collaboratively with representatives for ACOG and the March of Dimes to bring this bill quickly through state House and Senate committees and to the governor’s desk.
The legislation, introduced by Rep. Ryan Mackenzie, will establish a Maternal Mortality Review Committee including the Secretary of Health or her designee, an obstetrician, a maternal fetal medicine specialist, a certified nurse-midwife, a registered nurse representing maternal healthcare, a psychiatrist, an addiction medicine specialist, a social worker or social service provider, a medical examiner or coroner responsible for recording deaths, an emergency medical services provider, a health statistician, a representative of the department’s bureau of family health programs, three individuals specializing in emergency medicine, family medicine, pathology, anesthesiology, cardiology, critical care or any other relevant medical specialty, and additional personnel at the discretion of the secretary.
“As a midwife, I’m so glad to see this multidisciplinary effort come to fruition,” Perlman said. “We must listen to women, and the Maternal Mortality Review Committee is one way to honor the voices of women silenced too soon.”
In related news, Jefferson is leading a new coalition, the Philadelphia Collaborative for Health Equity (PCHE), to help to establish partnerships across the city aimed at better serving Philadelphia communities.
“Philadelphia has one of the highest maternal mortality rates in the country despite the presence of excellent medical facilities,” said Jack Ludmir, MD, Jefferson’s associate provost for Community and Global Initiatives, executive director of PCHE and co-founder of Puentes de Salud (“Bridges of Health”). “Although no single factor is responsible for most of these deaths, being African American, poor, obese, abusing drugs, having mental issues and exposure to violence increases the risk of dying in pregnancy. PCHE seeks to address some of the factors associated with the tragedy of maternal death by using a community-driven, grassroots approach. PCHE will bring together multiple stakeholders to help improve the lives of Philadelphia residents, reduce the disparities in healthcare and hopefully save lives.”
Jefferson also is working to increase dialogue about diversity, health equity and social justice within the midwifery curriculum, said Lauren Arrington, adjunct professor of midwifery, who will be trained this summer as a Seeking Educational Equity and Diversity (SEED) facilitator by the National SEED project.
“The SEED approach reflects a life course perspective for healthcare training that has the potential to address implicit bias and empower providers to address systems issues that impact maternal and women’s health,” she said. “As a facilitator, I will support colleagues and students to have meaningful discussions about issues of diversity and inclusion. These conversations allow us to delve inward to our personal experiences and reflect on how these issues impact our community as a whole. The process promotes personal, organizational and societal change toward creating a more just world.”