Department of Health receives federal grant to help reduce maternal mortality in Hawai‘i

The Hawai‘i State Department of Health, Maternal and Child Health Branch, has received $295,000 in federal grant funds to support efforts to prevent maternal mortality and to support maternal mortality review committees.

Maternal mortality rates in the United States are higher than in many other developed countries. Approximately 10 to 12 women die each year in Hawai‘i as a result of pregnancy or pregnancy-related complications, with more than half of those deaths deemed preventable.

“In partnership with the DOH, the Hawaiʻi State Legislature authorized the establishment of the Hawai‘i Maternal Mortality Review Committee in 2016 to review cases of maternal mortality, collect accurate data, and develop strategies for prevention,” said Kimberly Arakaki, Maternal and Child Health Branch chief. “This statute allows DOH to conduct multidisciplinary and multiagency reviews of maternal deaths to reduce the incidence of preventable deaths.”

The Department of Health statewide strategic plan is to maintain and expand the Hawai‘i Maternal Mortality Review Committee, which the grant will help to accomplish. The Hawai‘i Maternal Mortality Review Committee identifies the root causes of pregnancy-associated deaths and the key points where intervention may have prevented these deaths.

The committee will focus on the social determinants of health, including disparities in access to care; specific needs of indigenous populations, and root causes of complications and morbidity in pregnancy, including substance use disorder, mental health, and adverse childhood events.

During the five years of reviews (2017-2021) conducted by the Hawai‘i Maternal Mortality Review Committee, a total of 69 cases (death years 2015-2021) of pregnancy-associated deaths statewide were identified. The committee began making recommendations based on the preventable causes of death identified in the review.

These include improved continuity of care; improved education for patients, communities, and providers about substance use, motor vehicle safety, and perinatal mental health conditions; more robust and universal screening; referral to treatment practices; and patient safety bundles for hospitals related to sepsis, hypertension, and hemorrhage.

“Maternal morbidity and mortality do not affect all mothers equally,” said Dr. Pai-Jong Stacy Tsai, OB-GYN at the Kapiʻolani Medical Center for Women & Children and HMMRC member. “To understand this nationwide epidemic, cases of maternal death must be thoroughly reviewed, including the medical, social, and societal circumstances surrounding them. Specifically, this information can be used to inspire action in eliminating racial disparities.”

The grant will also help to fund key initiatives of the Maternal and Child Health Branch and the Hawai‘i Maternal and Infant Health Collaborative, which MCHB supports with funding and resources. The Hawai‘i Maternal and Infant Health Collaborative implements projects through a health or community-based organization that focuses on increasing access to birth control methods, family planning, and preventing the spread of sexually transmitted infections and diseases (STIs and STDs).

Maternal and Child Health Branch and Hawai‘i Maternal and Infant Health Collaborative initiatives include:

• Supporting perinatal behavioral health to prevent maternal deaths related to perinatal mood, anxiety disorders, and substance use disorders of women.
• Supporting an agency to provide a mobile clinic for perinatal assistance to people in poverty and homeless as they have limited access to prenatal education, care-enabling services, healthcare, and behavioral health care.
• Coordinating a diversity and inclusion conference on Oʻahu for healthcare workers, hospital administrators, obstetric care medical directors, midwifery professionals, and community leaders.
• Implementing paid media campaigns to support maternal health by increasing awareness of serious pregnancy-related complications and to empower people, especially Native Hawaiian and Pacific Islanders who are pregnant and postpartum, to speak up and raise concerns.

To learn more, visit health.hawaii.gov/mchb.