HJBR Jul/Aug 2021

34 JUL / AUG 2021 I  HEALTHCARE JOURNAL OF BATON ROUGE LDH CORNER members and providing the underlying data to support the work. PAMR, through epidemiological sur- veillance, identifies the deaths of women during pregnancy or within one year of the end of pregnancy, regardless of cause. Through a standardized, multidisciplinary process, maternal mortality cases are re- viewed to determine the cause, how it’s as- sociated with or related to the pregnancy, and identify areas of prevention. Action- able, evidence-informed recommendations for healthcare providers and health sys- tems, public health entities, community and families, and policymakers are developed to inform actions to reduce preventable causes of maternal mortality. The recom- mendations generated from the 2011-2016 Maternal Mortality Review were key to de- veloping the Reducing Maternal Morbidity Initiative for the LaPQC. The 2011-2016Maternal Mortality Review process provided a very high level of visi- bility into maternal deaths in Louisiana, but it had its limitations: that review looked at deaths within six weeks of pregnancy. The expansion to a one-year window for the 2017 PAMR review, which was completed last year, will provide us with a much wider ity improvement through the Louisiana Department of Health’s Bureau of Family Health. Housed within the Office of Public Health, the Bureau of Family Health works to promote optimal health for all Louisiana women, as well as their children, teens and families. The bureau has worked to priori- tize engaging with communities, providers and public health officials tomeet the needs of women, their infants and their children, and we have become very focused on the policy work that supports these programs. Two foundational programs within the Bureau of FamilyHealth are the Child Death Review and the Pregnancy-Associated Mortality Review, often known by its abbre- viation, PAMR. These two programs identify the causes of maternal and infant mortality and develop the recommendations that are implemented by other programs within the Bureau. PAMR, specifically, identifies the drivers of maternal mortality that informs the work of the Louisiana Perinatal Quality Collaborative (LaPQC) to implement solu- tions. The LaPQC in particular has been critical in working with the provider com- munity to improve outcomes, with PAMR informing the priorities among LaPQC’s WE have been fortunate over the last few years that there’s been much-improved public awareness around of the dismal ma- ternal and infant outcomes in Louisiana. Public support for improving these out- comes is critical if we are to make sustain- able change, and we need to do everything we can to make sure that patients and pro- viders alike are having meaningful discus- sions about how to prevent maternal mor- tality and morbidity, particularly among our most vulnerable populations. The data tells a very troubling story about where we are as a state: Louisiana has one of the worse maternal mortality rates in the United States, and in 2020, we received an “F” grade from the March of Dimes for our high pretermbirth rate, which was at 13.1%.1 For our vulnerable populations, racial dis- parities in maternal and infant outcomes are well documented: Black women expe- rience a pregnancy-associated death at a rate twice that of their white counterparts, and Black women in Louisiana experience a preterm birth rate that is 55% higher than that of other women. This data should shock us all, and the public’s knowledge and understanding of these outcomes have fu- eled our efforts to pursue continuous qual- COLUMN LDH CORNER Improving Maternal Outcomes IN LOUISIANA