A analyzing maternal mortality in Missouri and published Monday found that women on Medicaid are eight times more likely to die within one year of pregnancy than their counterparts with private health insurance.
It also found Black women in Missouri were three times more likely to die within a year of pregnancy than white women.
The annual report published by the Missouri Department of Health and Senior Services and compiled by the state鈥檚 Pregnancy-Associated Mortality Review board assessed maternal deaths from 2017 to 2019.
It found that each year an average of 61 Missouri women died while pregnant or within one year of pregnancy, putting the state鈥檚 pregnancy-related mortality ratio at 25.2 deaths per 100,000 births. Overall, 74.5% of deaths were determined to be preventable 鈥� with a little over half of those deaths occurring between 43 days and one year postpartum.
The report found disparities continued to persist in which women are at a higher risk of dying during or after childbirth.
Mental health conditions were the leading underlying cause of death, with all pregnancy-related deaths attributed to a mental health condition determined to be preventable. Patients whose birth was covered by Medicaid made up the largest percentage of pregnancy-related deaths at nearly 53%.
Among the top recommendations outlined in the report was for the state legislature to extend Medicaid coverage for pregnant Missourians to one-year postpartum 鈥� .
Meanwhile, a bill passed in 2018 by lawmakers to authorize the extension of Medicaid benefits to a year postpartum for women with substance use disorders.
Other recommendations include funding Medicaid expansion by 2023, establishing a statewide 鈥淧erinatal Psychiatry Access Program鈥� to assist with providing mental health care, like treatment for substance use disorders and improving screening and treatment for mental health conditions during and after pregnancy.
Missouri鈥檚 maternal mortality rate , and Monday鈥檚 report underscores the state鈥檚 abysmal ranking that .
鈥淢aternal mortality events, those where a mother dies during or shortly after pregnancy, are internationally viewed as an indicator that may be used to judge the overall health of a country, state, or community,鈥� Monday鈥檚 report read.
The report identified a variety of factors that contributed to Missouri鈥檚 maternal mortality rate, including late entry into prenatal care, especially for Black residents, and challenges ensuring rural patients can access adequate care for high-risk pregnancies 鈥� although pregnancy-associated deaths most frequently occurred in the state鈥檚 metro areas.
Mental health conditions, like substance use disorders and depression, were the leading cause of death, followed by cardiovascular disease. Among deaths caused by an injury, overdoses were among the most frequent, followed by firearms, including homicides.
鈥淚n half of these cases, the records provided to the PAMR program indicated a history of (domestic violence),鈥� the report read. 鈥淚n each of these homicides, the perpetrator was a current or former partner.鈥�
The majority, or 63%, of pregnancy-related homicides were Black women, while pregnancy-related suicides were all among white women, according to the report.
The report also assessed the prevalence of other health issues like obesity, hypertension and diabetes, and factor鈥檚 like a women鈥檚 age, education level and whether they had health insurance.
The report noted that while three years of data allows for a more comprehensive analysis, numbers should still be approached with caution as the overall dataset is small.
A recent analysis by The New York Times found that states with higher maternal mortality rates and weaker social safety nets . Abortion , except in the case of medical emergencies, after the fall of Roe v. Wade.
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