Could Expanding The Role Of Nurses Reduce Pregnancy-Related Deaths In Arkansas?

Aug 8, 2017

Number of deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100,000 births.
Credit CDC, National Vital Statistics System

The politics of public health will be at play as Arkansas moves forward with studying pregnancy-related deaths.

Arkansas has the third-highest rate of women who die during pregnancy or delivery, according to the United Health Foundation. This has prompted a study into the matter.

Maternal mortality is a complex problem, with many factors at play: complications like obesity, high blood pressure, diabetes, cesarean delivery and late prenatal care.

The lawmaker working on the study in Arkansas, Democratic Representative Greg Leding of Fayetteville, said it's hard to study maternal mortality without delving into a larger debate: the dispute over expanded roles for nurses.

Nurses have been asking for more autonomy so they can cover doctor shortages or a lack of access to care in rural areas. This means sometimes having the authority to practice without close doctor supervision.

"During every legislative session there are pretty fierce battles over scope of practice. Nurses would like to see their roles expanded and doctors, a lot of times, see that as nurses stepping onto their territory. I don't want the study to become a vehicle for any one group to advance its own agenda," said Leding.

Therefore, Leding said, he thinks it will be important to explore whether expanded roles for nurses could indeed lower pregnancy-related deaths moving forward.  

"If they were allowed to do a little bit more they could fill gaps that aren't currently served by physicians in parts of the state. Speaking with a nurse who reached out to me just this morning, she feels that there's such demand on a doctor's time, and so women who are pregnant might have more time to spend with the nurse and be able to have more questions answered or just receive more information that could be helpful throughout the pregnancy," said Leding.

Leding said he is working on forming a maternal mortality review committee and said he hopes to have results of the study in the coming year.  

But, no matter which side of the debate you land on, Dr. Lisa Hollier who heads Texas's Maternal Mortality and Morbidity Task Force told NPR, "Access to health care across a woman's lifespan is incredibly important, and things that we can do to permit that access are very important."