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Doctors Testify on Infant, Maternal Mortality in Kentucky

From the Legislative Research Commission:

What can be done to lower the rate of infant and maternal deaths in the Commonwealth?

Three Kentucky doctors testified before the Interim Joint Committee on Health, Welfare and Family Services yesterday on the causes of infant and maternal mortality.

Aside from congenital malformations, or birth defects, the reason infants are dying within the first month of life is often obstetrically related, or related to the health of the mother, according to the doctors’ testimonies.

For Kentucky, substance use disorders and mental illnesses are major factors in maternal death, where a mother dies during pregnancy or within a year of giving birth, said Dr. John Weeks with Norton Healthcare.

“In the last four to five years, there’s been at least a 25% increase in maternal mortality attributable to addiction,” Weeks said.

Mothers with substance use disorders who die during pregnancy or within a year of giving birth are mostly dying of overdoses, Weeks said. And these mothers are usually people who have struggled with substance use disorders for a long time with multiple relapses and they often also struggle with depression, anxiety or other mental illnesses.

Dr. Connie White, deputy commissioner for clinical affairs for the Cabinet of Health and Family Services, said 50% of maternal deaths had some type of substance abuse as a factor, whether that be an overdose, a car accident or a cardiac event.

While lawmakers have passed several laws in the last few years to study infant and maternal mortality as well as a law to require Hepatitis C testing in pregnancy, there is more work to do to improve this issue, the doctors said.

In Kentucky, Weeks said a major issue is there are not enough mental health professionals to reach all the areas of the state that “desperately need this kind of help.”

Committee co-chair Sen. Ralph Alvarado (R-Winchester), who also sits on the Severe Mental Illness Task Force, shared he and the committee are aware of the low number of mental healthcare providers in Kentucky.

“I’ll throw this statistic out there: 350 psychiatrists for the entire state of Kentucky, about a little bit under 60 child psychiatrists in the state of Kentucky. We are woefully deficient in that regard,” Alvarado said.

Rep. Tom Burch (D-Louisville) asked the doctors what other developed countries are doing to keep infant and maternal death rates low.

Dr. Jeffrey Goldberg responded by commenting on how the US healthcare system spends its money.

“We have a value problem, basically,” Goldberg said. “We are not spending our money wisely. It is not really a deficit of technology.”

Goldberg is a Louisville obstetrician and gynecologist who serves as the legislative advocacy chair for the Kentucky section of the American College of Obstetricians and Gynecologists.

“If we want to improve infant mortality, neonatal mortality, again, it’s really a matter of improving obstetrical care,” he said. “…How are we doing related to other Western countries? And the answer is that the U.S. has the worst infant mortality rate in the entire Western world. And we feel that given our resources that’s simply unacceptable.”

At the conclusion of the doctors’ presentation, Alvarado said the committee looks forward to hearing more throughout the interim on what can be done to improve infant and maternal mortality rates in next legislative session.

The next Interim Joint Committee on Health, Welfare and Family Services meeting will take place at 1 p.m. on July 21.

Photo: Sen. Julie Raque Adams (R-Louisville) asking Dr. Connie White, who is testifying virtually, a question about testing mothers for Hepatitis C (via LRC)