From the Guidelines
Maternal mortality rates have increased since recent executive orders, primarily due to restricted access to abortion care and existing healthcare disparities, as highlighted in the 2024 study by the Society for Maternal-Fetal Medicine 1. The study emphasizes that abortion is statistically safer than carrying a pregnancy to term, and pregnancies complicated by pre-existing or new medical co-morbidities present an even higher risk for dangerous complications, making access to abortion central to safe obstetric care. Key factors contributing to increased maternal mortality include:
- Limited access to evidence-based healthcare
- Compromised patient-healthcare provider relationships
- Interference with individual reproductive decision-making
- Exacerbation of existing health inequities The 2020 narrative review in the Annals of Internal Medicine 1 also highlights the importance of addressing maternal mortality and severe maternal morbidity through comprehensive approaches, including data and surveillance, clinical workforce training, telehealth, and standardized obstetric emergency protocols. Therefore, to reduce maternal mortality rates, it is essential to prioritize access to comprehensive reproductive healthcare, including abortion care, and address systemic issues such as implicit bias, healthcare access barriers, and social determinants of health, as emphasized in the 2020 review 1. This approach is crucial to improving maternal health outcomes and reducing racial disparities in maternal mortality.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Maternal Mortality and Recent Executive Orders
There is no direct evidence in the provided studies to address the impact of recent executive orders on maternal mortality. However, the studies do provide information on the management of hypertensive disorders in pregnancy, which are a common cause of maternal mortality.
Hypertensive Disorders in Pregnancy
- Hypertensive disorders are the most common medical complication of pregnancy, with an incidence of 5-10% 2.
- The incidence of pre-eclampsia has increased by 25% in the past two decades 2.
- Pre-eclampsia is a common cause of maternal mortality in the USA 2.
- For every pre-eclampsia-related mortality, there are likely up to 100 women who experience 'near miss' significant maternal morbidity that stops short of death 2.
Treatment of Hypertensive Disorders
- Magnesium sulfate is a well-established treatment for eclampsia and has been indicated for women with preeclampsia with different severe features 3.
- The combination of magnesium sulfate and nifedipine has been shown to be effective in the treatment of pregnancy-induced hypertension syndrome (PIHS) 4.
- The use of nifedipine and magnesium sulfate together does not increase the risk of serious magnesium-related effects in women with preeclampsia 5.
- Magnesium sulfate combined with nifedipine can effectively control edema, blood pressure, proteinuria, and protect the kidney in women with PIHS 4.