Maternal Mortality: An Epidemic in Georgia - Jacob Hays

Hello, everyone. I’m Jacob Hays, a second-year general body member of API from Roswell, GA. Outside of API, I’m majoring in Political Science and Public Relations with a minor in English. In 2021, I founded Georgia For Change, a nonpartisan, nonprofit advocacy group that has introduced and passed legislation in the Georgia General Assembly and written for the AJC. This week, I’m writing about an ongoing epidemic in Georgia: Our state’s maternal mortality rate.

Georgia has the eighth highest maternal mortality rate in the United States, with 28.8 women per 100,000 live births dying while pregnant, during childbirth or 42 days after childbirth. [1] These numbers are disturbing. 

If the state of Georgia were a country, it would have a maternal mortality rate higher than 72 other countries, including nations with far fewer economic resources, such as Chile, Grenada and Iran. [2] 

Among women of color in Georgia, these data are even worse. In 2019, Georgia had a maternal mortality rate of 98.4 women of color dying per 100,000 live births — a more than threefold increase from Georgia’s already unacceptable baseline. [3] The maternal mortality rate for women of color is worse in the state of Georgia than it is in the country of Syria, which is currently embroiled in a civil war. [4]

In 2023, Emory’s Woodruff Health Sciences Center and Research!America commissioned Zogby Analytics to conduct a survey on Georgians’ perception of the healthcare system. [5]  The survey revealed that one in 10 Georgians — a staggering 10% of Georgians —  know someone “[who] died during pregnancy, at delivery, or within 12 months after [delivery from related complications].” [6]

For those who don’t like numbers (trust me, I get it), I’ll just tell you what’s what. Far too many Georgians are dying because they wish to bring life into this world and build a family of their own. Far too many Georgians are dying because we’re fixin’ to do something instead of actually doing something. Far too many Georgians are dying preventable deaths.

Solving Georgia’s maternal mortality epidemic is complex. There are many causes of high maternal mortality — including economic, environmental and social factors; a lack of accessibility to high-quality healthcare, both preventative and ongoing; etc. [7] However, despite its complexities, the Georgia General Assembly can and should create meaningful policies to address maternal mortality. I focus on one such policy: Creating a Certified Community Midwife Board.

In Georgia, 56 counties — 35% of its counties — are “Maternity Care Deserts.” [8] There is a shortage of healthcare workers in Georgia, which is only growing. [9] In other words, there is a current and growing need for professionals who can augment “traditional” healthcare workers, such as doctors and nurses.

For maternal healthcare, midwives can augment the work of healthcare workers. In fact, studies show that midwife care generally leads to a less expensive, more pleasant, and safer maternal experience. Moreover, the Black community has a rich history of midwives, making it uniquely positioned to solve Georgia’s severely race-based disparities with maternal mortality. [10]

Midwife-led care is, on average, over $2000 cheaper than obstetrician-led care. [11] Midwife-led care is associated with statistically significant greater self-reported feelings of autonomy and respect and fewer self-reported feelings of mistreatment. [12] Most importantly, “a substantial increase in coverage of midwife-delivered interventions could avert 41% of maternal deaths.” [13]

According to a 2018 study, Georgia had the 18th lowest score for integration of midwives. [14] In that same study, the researchers found that states with greater integration of midwives were associated with better maternal health outcomes. Almost 40 states have licensed community midwives; Georgia does not. [15] 

Pursuant to O.C.G.A. § 31-26-2 and Rule 511-5-1-.02, midwives must receive a license through the Georgia Board of Nursing. However, due to this licensure regime, midwifery is primarily restricted to nurses, significantly limiting its possibilities. [16] A Certified Community Midwife Board, independent of the Georgia Board of Nursing, will expand community midwifery opportunities while providing more precise oversight and training. [17]

In 2023, legislators in the Georgia General Assembly introduced SB 81 and HB 684, which would establish a Certified Community Midwife Board for Georgia. However, despite the evidence that this legislation will help address the maternal mortality epidemic in Georgia, neither bill has advanced.

We must address maternal mortality. We must follow the evidence. We must take a step in the right direction. And we must urge our legislators to support SB 81 and HB 684 so Georgia takes a step in the right direction and saves our mother’s lives.