State experts call Alaska’s maternal mortality rate ‘a call to arms’

a graph of Alaska maternal deaths
More than half of Alaska’s 2021 maternal deaths occurred in Southwestern Alaska. (Maternal Child Death Review Committee/Alaska Department of Health and Social Services)

Maternal deaths went up 40% nationwide in 2021. The rate also went up in Alaska.

Alaska has its own way of measuring maternal mortality, so comparisons to national rates are tricky. But in 2021, Alaska reported its highest number of pregnancy-associated deaths in the last decade — more than double the most recent five-year average.

Ness Verigin leads the Maternal Child Death Review program for the state. They called the increase a call to arms.

“We had a tragic number of maternal deaths and pregnancy associated deaths during that year,” Verigin said.

Twenty mothers died.

The Maternal Child Death Review looks at deaths that happen from the start of pregnancy until one year after a pregnancy ends. Verigin says that in Alaska, most of these deaths don’t happen during labor. Instead, they happen because of violence afterwards. More than half of maternal deaths in the last five years were linked to intimate partner violence – Alaska has some of the highest intimate partner violence rates in the nation.

“Pregnancy-associated deaths due to violence are what we’re really looking at, because that’s where we’re losing most maternal life,” Verigin said. “Even when we’re looking at deaths from overdose and suicide, we more often than not find a history of trauma and violence.”

There’s another factor that may have influenced the spike in maternal mortality in 2021: the COVID-19 pandemic. During Alaska’s delta wave, state physicians spoke out about how overcrowding and rationed care at hospitals had a devastating effect on the maternity ward. And national data shows an uptick in violence against women throughout the pandemic years.

Most maternal deaths in Alaska happen more than 42 days after delivery. Earlier this year, Gov. Mike Dunleavy announced a bill that would extend postpartum Medicaid coverage from sixty days to a full year. The bill would increase access to care for treatable illnesses, like postpartum depression.

The state and grassroots organizations are working to address the issue. Alaska Native women are disproportionately represented among maternal deaths. The Alaska Native Birthworkers Community is a volunteer-led non profit that offers birth and postpartum support to address the disparity.

Verigin also manages a new program that provides free doula support and culturally competent care to pregnant people.

“It’s kind of become the latest big thing: cultural doulas and doula support as maternal mortality prevention — and doula support as violence prevention,” they said.

The program’s aim is to prevent maternal deaths from violence and it expanded from its 2021 pilot program last year. Verigin says they can see that it’s working.

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