Editorial  |   April 2019
Toward Improved Maternal Safety, with a Clarification and Apology
Author Affiliations
  • N. Martin Giesecke, M.D.
    Editor, ASA Monitor
Article Information
Cardiovascular Anesthesia / Central and Peripheral Nervous Systems / Geriatric Anesthesia / Obstetric Anesthesia / Editorial
Editorial   |   April 2019
Toward Improved Maternal Safety, with a Clarification and Apology
ASA Monitor 4 2019, Vol.83, 4-5.
ASA Monitor 4 2019, Vol.83, 4-5.
My last editorial on obstetrical anesthesiology was published in the March 2017 ASA Monitor. In that column, one of my main topics was the relatively high maternal mortality rate in Texas, around 31.5 per 100,000 live births. That was data from 2014. We now have 2018 data. Texas’ maternal mortality increased to 34.2 per 100,000 births.1  While this is still not a number to be proud of, there are states with worse numbers: Arkansas, 34.8; New Jersey, 38.1; Indiana, 41.4; Louisiana, 44.8; and Georgia, 46.2.1  These six states with the worst maternal mortality in the U.S. are a far cry from the five states with the lowest rates of maternal mortality: California, 4.5; Massachusetts, 6.1; Nevada, 6.2; Colorado, 11.3; West Virginia, 11.7; and Alabama, 11.9.1  A State of Texas study, published in 2016, showed that the leading causes of maternal mortality were cardiac events, overdose by legal or illegal medications and hypertensive disorders.2  Even more concerning remains the differences in mortality rates in different demographic groups. Black women in Texas had a mortality rate of 85.6 per 100,000 births, compared to Caucasian women (38), Hispanic women (20.5) and Asian/Pacific Islander women (16.9).1 
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