First Five Nebraska Policy Advisor Sara Howard testified before the Nebraska Legislature’s Health and Human Services Committee at a recent hearing on LR221, Senator Tony Vargas’ interim study of maternal and infant mortality and morbidity.
Panel created after record number of deaths
The Nebraska Child Death Review Team was created in 1993 after the state recorded more than 300 child deaths in the year prior, and the statute remained unchanged until 2013 when revisions were passed into law. The 2013 legislation included definitional changes and added reviews of maternal deaths, defined as the death of a woman during pregnancy or the death of a postpartum woman up to one year after she ceases to be pregnant. Those revisions were implemented in 2014. The original core purpose of the Maternal and Child Death Review Team was to advise the Governor, the Legislature and the public on changes to law, policy and practice to prevent maternal and child deaths.
The most recent findings from the Maternal and Child Death Review Team were released in September 2017 with information on deaths that occurred in 2012 and 2013. At that time the top five causes of death for the state’s children were pregnancy-related (133 deaths), birth defects (96 deaths), motor vehicle-related incidents (51 deaths), sudden unexpected infant death (41 deaths) and medical conditions (non-cancer; 35 deaths). It’s hard to know if these causes of death remain at the forefront in Nebraska because we do not have timely information from this team in the way it was envisioned in the original legislation.
In addition to First Five Nebraska, the Nebraska Medical Association, the Nebraska Perinatal Quality Improvement Collaborative, CityMatch, Children’s Hospital and the March of Dimes testified in person before the legislative committee, and the Omaha Women’s Fund and Douglas County Health Department submitted letters.
3 policy recommendations
First Five Nebraska highlighted three main policy suggestions for the committee to ensure timely, accurate and useable information is shared to prevent maternal and infant deaths in our state:
- Pass LB626 – Senator Vargas’s bill offers long overdue updates to the Maternal and Child Death Review Team structure; it was advanced unanimously out of the HHS committee during the 2021 legislative session;
- Clarify definitions to include fetal data in Section 71-3405 of the revised statute – When the 2013 revisions were passed, fetal deaths were inadvertently omitted and the language as currently written prevents the state from sharing data with counties around stillbirths;
- Consider state involvement and ownership of severe maternal morbidity reviews – While the state has a structure in place to consider maternal mortality, it is equally important to identify opportunities for preventable morbidity conditions.