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SPECIAL REPORT: Maternal death rate triples in Missouri

Missouri ranks 42nd in comparison to other states for the number of maternal deaths per 100,000 births. (KRCG)

New data showed Missouri ranks among the deadliest states in the country when it comes to pregnancy.

State Director of Health and Senior Services Dr. Randall Williams said Missouri came in at 42nd compared to other states for deaths during pregnancy or immediately afterward.

Prior to leading the Department of Health and Senior Services, Williams delivered babies for 30 years as an obstetrician.

He said during his work in the medical field, he saw that many of the cases of maternal death were preventable. "We know about 30 to 40 women in Missouri die each year," Williams said. "We want to find out exactly what they're dying from, because we believe most of these cases could be avoided."

According to data from the Department of Health and Senior Services, blood clots and cardiovascular diseases are the top two causes of maternal death.


"We can often prevent those, if we try to treat the chronic diseases that lead to them, and also do a very good job of recognizing the signs of what's coming," Williams said.

Jessica Fahnestock, a Jefferson City resident and mother of two, had her own difficulties during pregnancy, delivery and afterward.

"I love being a mom, it's what I'm meant to do," she said. "It's really beautiful, but sometimes it's ugly too."

Fahnestock didn't have a close call with an embolism or heart disease, but she said she experienced an emergency C section during her son Elias' birth.

"Because of that, I also had to have a c-section when my daughter Lilliana was born," she said. "Recovering from the same eight inch incision with less than 16 months in between isn't easy."

Dr. Williams said consistent prenatal care can help prevent complications during both pregnancy and delivery, so soon to be moms should see a doctor as soon as possible.

But Fahnestock said no amount of prenatal care could have helped what she eventually came to face after her daughter's birth.

"I almost lost her to a very contagious respiratory virus," she said. "I had to make sure she was healthy and strong, and she had her doctors appointments, but I also had to try to take care of myself."

She said that experience caused post-traumatic stress disorder. Since then, as the sole parent to two young children while her husband was deployed, Fahnestock said she's also suffered from post-partum depression.

Fahnestock said her medical exams after her daughter's birth were typically very basic.

"When we go in to see the doctor, that OBGYN checks on the baby. They check on you medically, but they don't check on you emotionally," she said. "They might ask you, 'How are you feeling?' Then they might look at your vitals, make sure you're good to go, then send you on your way."

Her newborn baby did recover from the respiratory virus. But on the other hand, Fahnestock said she didn't bounce back so easily - especially emotionally.

"I had to stay positive for my toddler. I had to smile, I couldn't cry. My husband was deployed," she said. "I had to be strong. I was alone. I didn't have anybody asking me anymore if I was okay."

Dr. Williams said post-partum depression can be an indirect cause of maternal death. Fahnestock said it's scary to think that what she's dealing with could lead a mom to take her own life.

She said she believes visits to the doctor for new moms and babies need to include more detailed questions about the mother's physical and emotional health.

"How do you feel about the pressures of being a new mom? How do you feel about your relationship with your baby? That sort of thing," she said.

On a larger scale, pregnancy-related deaths from both direct causes like embolisms and indirect causes like suicide affect 700 to 900 American women and their families every year, according to data from the Centers for Disease Control.

Compared to other developed nations - countries such as Canada, Japan, Great Britain, and Israel - the U.S. has the highest rate of maternal death.

The U.S. was also the only developed nation that saw maternal deaths increase in 2016. State health data shows Missouri is mirroring that trend:

Certain demographics are also disproportionately affected by maternal death; for example, African American women in Missouri are more than twice as likely as Caucasian women to die during the maternity period.

Williams said he believes one way to decrease the number of maternal deaths is to ensure every woman has better access to pre- and postnatal care. "There are 67 counties in Missouri that do not have a practicing obstetrician, gynocologist, or obstetrician-gynocologist," he said. "That means a lot of our women cannot easily go see a doctor if they have questions or concerns. If those who live in rural areas had better access to care, I think that could really make a difference."

If you or someone you know has concerns about physical, mental or emotional health during pregnancy, delivery, or afterward, here are some of the resources available in Mid Missouri:

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