Task force approves recommendations to lawmakers to fight maternal mortality

(The Center Square) – A legislative task force this week finalized recommendations for lawmakers on addressing the state’s high rates of maternal mortality and preterm births.

The Nursing Maternal Mortality and Preterm Births Task Force unanimously approved on Wednesday a range of recommended strategies outlined in a draft report due to the Legislature “no later than forty-five days prior” to the start of the 2024 regular session on March 11.

The effort stems from Senate Concurrent Resolution 20 approved last session that requested the Louisiana Department of Health convene the task force to recommend ways to combat “one of the highest incidences of maternal mortality and preterm births in the nation.”

Louisiana’s maternal mortality rate of over 58 deaths per 100,000 births is the highest in the United States, with 68% of deaths deemed preventable. Nearly 13% of live births in Louisiana are preterm, according to the resolution.

The task force — nearly two dozen representing hospitals, nurses, state agencies, education programs, and licensing authorities — targeted three main priorities: Integrating certified nurse midwives in the health care system, supporting full practice authority for advanced practice registered nurses and increasing Medicaid reimbursements.

The task force aims to increase the number of practicing nurse midwives in Louisiana in several ways, including state tax deductions, funding for students who agree to practice in the state for two years, addressing regulatory and third-party payer barriers, free-standing birth centers and tax incentives, among others.

Recommendations also involve state funding for pregnancy and post-delivery programs for mothers and babies, as well as funds for programs to screen for depression and substance abuse. The task force suggests employing community health workers to make referrals and certified nurse midwives in maternity care deserts through partnerships with existing public service groups.

There’s also suggested funding for remote patient monitoring programs for pregnant and post-partum women, which could be implemented along with recommended mobile units equipped to handle issues with perinatal care, screening for depression, sexually transmitted infections, family planning, depression and others.

The task force report recommends utilizing school nurses to educate middle and high school students on reproductive health and calls for evaluating fees some physicians charge for required collaborative practice agreements with APRNs.

While the task force supports broadening the scope of what APRNs are authorized to do, it suggests the health department fund one or more physicians to collaborate with local health officials in maternity deserts if that doesn’t happen. Task force members noted states with more restrictions on APRNs have poorer maternal mortality outcomes than states with fewer restrictions.

Still other recommendations center on better integrating midwife services into the current health care environment, both in the state’s education systems and consortiums and in hospital and health care systems.

The latter could involve tax credits for hospitals and physicians who integrate certified nursing midwives into their practices and systems, task force members said.

The recommendations for lawmakers are in addition to, but align with many, suggestions outlined in a Louisiana Pregnancy-Associated Mortality Review produced by the Louisiana Department of Health aimed at addressing the same issues.