State Rep. Rita Fleming to focus on initiatives to improve maternal health during 2019 session

INDIANAPOLIS – During her first session as a member of the Indiana General Assembly, State Rep. Rita Fleming (D-Jeffersonville) intends to focus upon initiatives that will improve the health of Hoosier women before, during and after pregnancy.

Fleming said she is particularly interested in expanding ongoing efforts to reduce Indiana’s maternal mortality rate, which is nearly 41 deaths for every 100,000 women. That rate is twice as bad as the U.S. rate, which is the worst among all developed nations.

It is also something that Fleming has had to face during her work as a registered nurse, a nurse practitioner, and an obstetric hospitalist.

“Earlier this year, our state created the Maternal Mortality Review Committee, which carries a mission of changing those shocking numbers,” Fleming said. “My intention is to expand the scope of that study by offering legislation that enables the committee to review the costs of hospital care in maternal mortality cases.”

In recent weeks, Fleming has been meeting with key players like Indiana State Health Commissioner Kristina Box, as well as representatives from the Indiana State Medical Association, the Indiana Health Care Association, and the Indiana Centers for Assisted Living.

“Our goal is a comprehensive study of maternal deaths in Indiana,” Fleming said. “A similar study was the starting point in a review conducted in California, which resulted in the numbers of maternal deaths in that state being reduced by more than 50 percent.

“In my opinion, we begin by learning which deaths are preventable, and what improvements can be made to change that figure,” Fleming said. “In California, they found that the most common causes of preventable deaths were factors like cardiovascular disease, hemorrhaging, and complications from drug abuse.

“The next step would be identifying women at risk,” she added. “Ideally, this process would occur prior to pregnancy, so women can be in optimal health prior to conception. By ensuring good control of diabetes, hypertension and other medical conditions, we can make for healthier mothers and babies.

“Then would come early and individualized prenatal care,” Fleming said. “The best solution involves listening to patients and acting on their concerns so we can head off potential problems. For instance, if we make sure that patients are taking their iron pills for anemia in pregnancy, we can help head off a potential hemorrhagic event.”

Adding a review of hospital costs to the committee’s study would enable officials to understand the burdens that are faced by the families, as well as taxpayers.

“For example, a woman who experiences a fatal catastrophic hemorrhage just after delivery often will require transfusion of numerous blood products, a hysterectomy, Intensive Care Unit (ICU) expenses, medications, lab work, and on and on,” Fleming noted. “The costs can easily exceed $100,000…and more importantly, the baby doesn’t have a mother. You cannot understand the true scope of protecting maternal health without consideration of the cost.

“I also believe that we need to make sure that our efforts in Indiana are adequately funded,” Fleming said. “The Preventing Maternal Deaths Act, which has passed both the U.S. House and Senate and is awaiting final approval by the President, provides a means to study maternal mortality, and we need to take full advantage of the support it will provide to supplement our study.

“And there are other factors at play here that demand our attention,” she continued. “I want to work with public health officials to have reliable birth control methods available at syringe exchange programs and drug treatment facilities. The challenge here is great, but it can be achieved.”