Physicians back programs to address maternal mortality, depression

Brendan Murphy , Senior News Writer

The AMA House of Delegates (HOD) took several actions aimed at protecting the lives and improving the health of new and expectant mothers and their children, during the 2017 AMA Interim Meeting in Honolulu.

Pregnancy-related deaths have doubled in the United States the past 25 years, according to the Centers for Disease Control and Prevention. In light of that fact, the HOD moved to refocus efforts to prevent maternal death. Delegates adopted policy calling on the AMA to “support the important work of maternal mortality review committees.”

To facilitate the existence of maternal mortality review committees, the new policy also instructs the AMA to “work with state and specialty medical societies to secure funding from state and federal governments that fully supports the start-up and ongoing work of state” maternal mortality review committees. The AMA also will advocate state and federal legislation to establish such committees.

In other action, the HOD moved to address the treatment and diagnosis of maternal depression. At least one in seven women suffers from anxiety or depression during pregnancy or the year that follows the birth of a child, research shows. That makes mental health maladies the most common complication of pregnancy.

In response to the concern over pregnancy-related mental health issues, the HOD directed the AMA to:

  • Work with stakeholders to encourage the implementation of a routine protocol for depression screening in pregnant and postpartum women presenting alone or with their child during prenatal, postnatal, pediatric, or emergency room visits.
  • Encourage the development of training materials related to maternal depression to advise providers on appropriate treatment and referral pathways.
  • Support the development of state-based care coordination programs, such as staffing a psychiatrist and care coordinator, to assure appropriate referral treatment and access to follow-up maternal mental health care.

“As attention is turned toward the newborn, the health and wellbeing of the mother can, unfortunately, take a back seat, even as preventable physical and mental issues pose dangers. We need to recognize that dangers of post-partum depression and recognize that pregnancy-related deaths have been increasing,” said Albert J. Osbahr III, MD, a member of the AMA Board of Trustees.

The most recent data from the U.S. Department of Health and Human Services indicate that more than 420,000 children are in the foster-care system. Children growing up in that system are far more exposed to adverse family experiences that can create symptoms related to “toxic stress,” according to the authors of a resolution adopted by the HOD.

Such trauma can affect a child’s immune system, neurodevelopment and genome, the resolution’s authors argue. The resulting complications can include delays in development and poor health outcomes well into adulthood. In a move to address the unique needs of children in foster care, delegates adopted new policy that calls on the AMA to “advocate for comprehensive and evidence-based care that addresses the specific health care needs” of children in foster care.

Read more news coverage of the 2017 AMA Interim Meeting.