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New survey illustrates scale of maternal health crisis in Georgia

Full article on the Atlanta Journal-Constitution.

One in 10 Georgians know of someone who has died during pregnancy, at delivery, or soon after giving birth.

That’s the topline finding of a sprawling survey conducted in October by Emory University’s Woodruff Health Sciences Center in collaboration with Research!America, a health research advocacy group. The results of the public opinion poll were unveiled today at the inaugural Symposium to Address the Maternal Health Crisis in Georgia, which is taking place at Emory and will also feature personal testimonies by individuals and families affected by maternal mortality.

Elsewhere in the Emory and Research!America survey of over 1,400 Georgians, nearly 60% of respondents noted that they have experienced or know someone who has experienced complications during pregnancy. More than a third of the people polled noted that racism is a major obstacle to achieving equal health outcomes.

Experts say the data serves as confirmation of the outsized toll that the maternal mortality crisis is taking on Georgia, where the rate of pregnancy-related deaths is among the nation’s worst, and where Black women face triple the odds of dying from pregnancy-related complications than white women.

Dr. Ravi I. Thadhani is the executive vice president for health affairs at Emory University. He says the results of the survey released today act as additional confirmation of the “widespread impact” of the maternal health crisis in Georgia, which he noted also changes the lives of women’s families and their children.

“The downstream effects are perverse.”

Perhaps because of the first-hand experience many poll respondents said they had with negative maternal health outcomes, many also registered a wish for the status quo to improve. That applies to participants from both sides of the political spectrum: 89% of Democrats and 74% of Republicans agreed that it is important for elected officials to support efforts to reduce maternal mortality.

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“The idea that this would be a partisan issue, I think we can put aside because it’s not a partisan issue. It’s an issue that affects every individual in this state, and especially pregnant women,” Thadhani said. “And as a result, we need to come together as a state to address this crisis.”

In 2020, the Georgia Legislature expanded Medicaid coverage for new moms, making it accessible from pregnancy until one year after giving birth. That is meant to address the biggest portion of moms who die from pregnancy: Those who die many weeks or months after giving birth, often from problems with the heart or blood that weren’t caught in health checks.

In all, the leading cause of maternal deaths in Georgia are hemorrhage; mental health conditions; cardiovascular or coronary conditions; embolism; and preeclampsia or eclampsia, according to a report released earlier this year examining deaths from years 2018 to 2020.

Respondents to the Emory and Research!America poll perceive substance use disorders (47%), lack of insurance (47%), and mental health challenges (41%) as the top factors likely to yield an increased risk of maternal mortality.

Health equity

When it comes to Black women’s heightened risk of pregnancy-related complications, the data is unequivocal, showing disparities in maternal-health rates that cut across all education and income levels. Instances of doctors, nurses or aides failing to take patients’ complaints — among the biggest lost opportunities to save a life — are especially harmful to Black patients, research suggests.

In the Georgia survey results published today, African Americans are 48% more likely to face a lack of available appointments. In addition, they are 23% more likely to run into issues securing transportation and 23% more likely to have to go to a hospital or a clinic that is too far from home.

In total, 49% of Black respondents and 41% of Hispanic respondents noted racism is a “major obstacle” to patients achieving equitable health outcomes.

Overall, 61% of the survey’s respondents said they think that the health care system treats people unfairly based on their ethnic or racial background. That same percentage also said people may be treated unfairly based on their level of English fluency.

Cost barriers to care

According to more than half (54%) of Georgians polled, the top barrier to health care is its high cost, even with insurance – something that only about 70% of respondents said they had.

Over 70% of respondents said that improving the affordability of maternal health care and expanding access to health insurance coverage should be top priorities when it comes to making headways in reducing maternal mortality.

Tuesday’s symposium is being held in partnership between Emory University’s Woodruff Health Sciences Center, Research!America, Morehouse School of Medicine and the Mercer University School of Medicine, among other organizations in Georgia. The purpose of the meeting is to bring the state closer to solving its maternal health crisis by opening a new chapter of collaboration. Aside from university researchers, it will bring together stakeholders across health care, state and federal governments, community partners, and advocacy groups.

As Thadhani noted, despite there being no shortage of awareness about challenges faced by Georgia moms and moms-to-be, the “problems still exist, and in fact, in some circumstances they are even getting worse,” he said.

“So, what this symposium is going to do is say, ‘We’re doing really good work, but we are not making a dent on this problem. So therefore, we need to do something different.’ And what we could be doing different, is we could actually tackle this problem together in much more creative and innovative ways.”

Findings of Research!America and Emory survey on Maternal Mortality:

  • Many Georgians (57%) have experienced or know someone who has experienced complications during pregnancy and 10% know of someone who has died during pregnancy, at delivery, or soon after giving birth.
  • Rural respondents are more likely (65%) to say they have been or know someone who has experienced complications during pregnancy.
  • Respondents say racism is an obstacle to people achieving equal health outcomes. 36% say it is a major obstacle, 32% say minor obstacle, and only 23% say racism is not an obstacle.
  • Georgians say that improving affordability of maternal health care (73%) and access to health insurance coverage (70%) are top priorities to reducing maternal mortality.
  • Most Georgians (82%) across party lines (92% Democrats, 80% Republicans) say it is important for the state of Georgia to increase investment in initiatives to reduce maternal mortality.