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How can NJ reverse its high maternal mortality rates?

Smiles are nonstop in the Cherry Hill home of the Rivera family, and here’s why: three healthy baby boys, triplets Gabriel, Lucas and Xavier, all keeping mom Zoe Rodriguez Rivera and her army of helpers on their toes. But the joy of a new family, and miracle of multiples, almost wasn’t.

“Never in my wildest dream did I think that I was going to be presented with what happened after the cesarean,” said Rivera.

The 36-year-old lost half her body’s blood supply, experiencing a postpartum hemorrhage. It’s one of the top causes for maternal death in the U.S., requiring an emergency uterine embolization.

“Just the look of sheer fear in my husband’s eyes, I was like, ‘what’s going on,’ and the nurse told me, ‘you lost a lot of blood and we’re trying to figure out how to stop it. You’re clotting and we need to take you to the ICU,'” said Rivera.

Rivera’s story has a happy ending. But maternal mortality, or women’s deaths related to pregnancy or childbirth, is on the rise across New Jersey. In fact, the rate is nearly twice the national average, according to a 2016 Health of Women and Children Report from the United Health Foundation.

“I really think nationally we’re a little bit stumped on that, and that’s why we’re putting so many resources into looking at what we can do better. When we look at the avoidable outcomes, the avoidable causes of maternal deaths, the biggest factors are hemorrhage and hypertension,” said Dr. Nicole Lamborne, program director of Women’s Health for the Virtua Health System.

Medical experts are also stumped over racial disparities. Women of color account for nearly 60 percent of pregnancy related deaths as of 2013, the most recent data available, with black women accounting for over 40 percent of that number. Virtua Health System in Voorhees delivered Rivera’s babies along with nearly 6,000 others every year, so they’ve put coordinated responses in place.

“The process that we use alerts everybody in the hospital including the blood bank, we have all of our ICU staff, interventional radiology, so that everybody can be ready for these potential big hemorrhages,” said OB-GYN and laborist Dr. Amy Zehnder.

“So really that prenatal care, and going for consistent prenatal care, truly improves outcomes. Sometimes people start to feel like, why do I have to go every week, why do I need to go every two weeks, but it’s those constant check-ins at the higher risk times of pregnancy that allows us to see things that maybe you’re not feeling — a higher blood pressure, a change in your urine, a change in your weight,” said Lamborne.

The issue is on the minds of Senate Democrats, who plan to hold a hearing on this at the beginning of this legislative session to figure out ways to better support pregnant women and their babies.

“How can we improve housing, access to food, access to medications that are needed and ongoing support and education for the moms,” said Aline Holmes, senior vice president of clinical affairs at the New Jersey Hospital Association.

Education is a big component. Most women don’t know they’re at risk during the first two weeks following childbirth, and many have no prior health conditions. The push to create an official awareness day began six years ago by Ryan Hansen. An undetected infection took the life of his wife Tara just six days after giving birth to their first-born son.

“When I lost Tara in 2011, I guess I realized that it wasn’t a singular event. That this happens much more than we know and it’s something that we need to combat and do better at,” said Ryan Hansen, who founded the Tara Hansen Foundation.

His vow, along with so many others invested, is to prevent problems from falling between the cracks so those beautiful babies can go home with healthy mothers.