Commentary: Delaware celebrates Maternal Health Awareness Day

The Delaware Section of the American College of Obstetricians and Gynecologists (ACOG) was pleased to host its first Maternal Health Awareness Day on Jan. 23 at the Medical Society of Delaware’s Conference Center in Newark.

Maternal Health Awareness Day was first observed last year by the New Jersey Section of ACOG to promote the importance of maternal health. The Delaware Section has joined the effort to make this day a national observation and received recognition for this event by a proclamation from Gov. John Carney who acknowledged the importance of this cause.

The Delaware Section was joined by Sen. Tom Carper and Sen. Chris Coons who discussed national efforts to support maternal health. We were honored to have Senator Carper celebrate a small part of his birthday with us at this meeting. The senators were sponsors of S.1112 – Maternal Health Accountability Act of 2017 which will fund the establishment of Maternal Mortality Review Committees in each state.

The focus of this event has risen to national importance in light of evidence that the maternal mortality rate in the United States exceeds that of any other industrialized nation.

Approximately 700 women die each year in pregnancy related deaths resulting in a rate of 18 per 100,000 live births. This is the “tip of the iceberg” for more than 52,000 episodes of severe maternal morbidity in the United States each year. The purpose of this event was to highlight efforts to reduce the burden on mothers.

Dr. Haywood Brown, the immediate past president of the American College of Obstetricians and Gynecologists presented the concept of the fourth trimester of pregnancy. This is an effort to emphasize the importance of the postpartum period in the health of mothers. Only about half of women currently attend their postpartum appointment and opportunities to intervene in possibly life-threatening events are thereby lost.

ACOG now recommends a postpartum visit as early as one to two weeks after the delivery of a child, depending upon the circumstances of the pregnancy and delivery, followed by appropriate ongoing care as needed with a final visit at about 12 weeks postpartum.

The 12-week visit will serve as a transition to ongoing well-woman care and should include a full assessment of emotional well-being; infant care and feeding; sexuality, contraception and birth spacing; sleep and fatigue; physical recovery from birth; chronic disease management; and health maintenance.

This is also a period during which planning for future pregnancies can be made and more in depth discussions regarding contraception, if desired, can take place.

The meeting also addressed Delaware’s plans to address the rising maternal mortality rate.

Dr. Karyl Rattay, the Director of the Division of Public Health, discussed the efforts that the State is mobilizing. The Delaware Perinatal Quality Collaborative which was established several years ago has now obtained a grant from the Centers for Disease Control and Prevention to enhance the safety of neonatal and maternity care in Delaware.

The first major project is to assess the risk for obstetrical hemorrhage and to provide appropriate and standardized treatment throughout the state with all six of the birthing hospitals and the Birthing Center joining in this cooperative effort.

Finally, Upstream Delaware presented information regarding Delaware CAN’s (Contraceptive Access Now) progress report concerning the education of providers on long acting reversible contraceptive methods throughout the state.

The Delaware Chapter of ACOG was pleased to provide this program which successfully presented the ongoing endeavors in our state and nationally regarding improvement of maternal health. We are looking forward to the establishment of a national Maternal Health Awareness Day and expect to continue this as a tradition to be held on Jan. 23 every year. The Delaware Chapter of ACOG would welcome comments from the community regarding this project.

Garrett Colmorgen, M.D. is medical director of the Delaware Perinatal Quality Collaborative.

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