LOS ANGELES — Maternal mortality is on the rise in California, with African-American mothers roughly four times more likely to die from pregnancy-related causes than women in any other racial or ethnic groups, state health officials reported Tuesday.
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The overall rate of maternal deaths in 1999 was eight per 100,000 live births, and by 2008 that number had risen to 14 deaths per 100,000 live births, according to a California Department of Public Health study that cites federal statistics.
In a breakdown, the maternal mortality rate among African-American women was 36.1 per 100,000 live births, compared to 9.6 for white women and 8.5 for Hispanic women in 2008.
"That's very concerning, and it's a widening gap," said Dr. Connie Mitchell, the study's lead author.
To address the problem, state officials have expanded the Black Infant Health Program in the past year to include more outreach and information for black mothers-to-be, providing group sessions to keep tabs on progress through a healthy pregnancy, according to Mitchell.
Black mothers tend to have diabetes and high blood pressure at higher rates than other groups, and Mitchell said the program has provided information on improving those conditions through stress management and taking proper vitamins.
Low-income and women with less education were also more likely to face deadly complications in childbirth.
At least a third of the increase can be attributed to better tracking and reporting, according to the study.
The long-awaited state report was deemed necessary in 2004, and this year's release focuses on maternal deaths in 2002 and 2003. During the next three years, 2004 to 2007 will be examined, said Mike Sicilia, a spokesman for the state health department.
In 2002 and 2003, there were 39 and 51 pregnancy-related deaths in California, respectively.
Of those, 15 percent were caused by hemorrhaging, prompting the state to lead a collaborative effort for hospitals on best practices and best equipment, said Mitchell. Of the 280 hospitals in the state where childbirth occurs, more than 50 have gone through the training.
The study found that a number of factors affect maternal mortality, including the increasing age of mothers and the prevalence of maternal chronic conditions such as obesity.
Cesarean section delivery rates have been rising at the same time as increases in maternal morbidity, the study noted.
C-sections are surgical procedures with higher risks of complications such as infection, bleeding or blood clots when compared to vaginal births. There is also increased risk for complications in subsequent births after a C-section.
Mitchell stopped short of drawing a direct association between the method of childbirth and maternal mortality, noting that C-sections are often used to intervene in complicated births so their prevalence in cases of maternal death is not necessarily a cause of death.
The study also faults social factors, such as low levels of social support, lower socio-economic status and chronic exposure to stressors like racism.
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