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“Identifying, collecting, and reviewing maternal mortality data will help us develop and implement recommendations that will have a positive impact on the state’s maternal death rate.”


This past legislative session, the Texas


Medical Association worked to pass SB 495 and its companion, House Bill 1085 by Rep. Armando Walle (D-Houston). During the 2011 session, Representative Walle filed legislation to create a mater- nal mortality review process in the state, but it never made it out of the House Committee on Public Health. Margo Hilliard, MD, a pediatrician and senior vice president of Health and Wellness Services for the Harris County Health System, says Representative Wal- le was instrumental in generating sup- port for creating the Maternal Mortality and Morbidity Review Task Force. “His early leadership and support made passage of this legislation pos- sible,” Dr. Hilliard said.


The TMA Committee on Maternal and


the tragic toll of maternal death in the state. It creates the Maternal Mortality and Morbidity Review Task Force under the Texas Department of State Health Services (DSHS). Dr. Hollier, chair of the Texas District of the American Congress of Obstetri- cians and Gynecologists (ACOG), is passionate about reducing the maternal death rate in the state. She specializes in high-risk pregnancy, predominantly among Medicaid patients. “I think there is no question with the rising maternal mortality rates in Texas that this task force was needed. It’s time to start investigating these deaths and to identify potential prevention strategies


that can be implemented,” she said. The law took effect Sept. 1 and di-


rects the task force to study and review pregnancy-related deaths and to make recommendations to help reduce preg- nancy-related deaths and severe mater- nal morbidity in Texas. Severe maternal morbidity is any life-threatening health condition that occurs during pregnancy, labor, or delivery, or within the first year following pregnancy. An example is pre- eclampsia or high blood pressure during pregnancy.


“My legislation sends a strong message Margo Hilliard, MD Carla Ortique, MD 54 TEXAS MEDICINE September 2013


that Texas is serious about decreasing its maternal mortality rate and preventing poor health outcomes for countless other mothers,” Senator Huffman said. Without a state entity examining the causes of maternal deaths, Dr. Hollier says, physicians only had access to rel- evant data within their own institutions. “That’s very limiting and doesn’t give us the broad picture we need. The task force’s analyses and recommendations will help physicians make a difference in maternal health across multiple health systems,” she said.


Perinatal Health studied pregnancy-re- lated deaths in Texas and recommended policy on the subject at TexMed 2013. The policy, adopted by the TMA House of Delegates, directs the association to support having a qualified committee that reviews maternal mortality to im- prove services and systems to prevent future deaths. It also says TMA members should be on the task force and recom- mends the group use CDC’s national best-practice guidelines in creating and operating Texas’ maternal mortality re- view system. Carla Ortique, MD, a Houston ob- stetrician-gynecologist and chair of the TMA Committee on Maternal and Peri- natal Health, testified for the policy at a TMA reference committee meeting at TexMed. She said at the time Texas was the most populous state without a maternal mortality review process. Ac- cording to Amnesty International, Texas joins 23 other states that have maternal mortality review boards. “I am extremely excited and happy SB 495 passed. Identifying, collecting, and reviewing maternal mortality data will help us develop and implement recom- mendations that will have a positive im- pact on the state’s maternal death rate,” Dr. Ortique said.


Best of both worlds Dr. Hollier testified in support of HB 1085 before the House Committee on


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