Oklahoma’s expectant mothers receive some of the worst health care in the country. That’s according to a 2021 report that showed the Sooner State ranks 40th in maternal care.
According to the report, from 2016-2019, 23.5 of every 100,000 live births ended with the mother dying. The national rate for the same period was 20.1.
"People with lower incomes, poverty is a big contributor, and also with lower education levels also do have worse outcomes in pregnancy," explained OU's Professor of Maternal and Fetal Health, Dr. Stephanie Pierce.
Those numbers double for black women both in Oklahoma and across the country.
"When you hear about patients who feel like they're less heard or, or research and studies on implicit bias, it's multi-factorial," explained SSM Health Group OBGYN, Dr. Angela Hawkins.
Many of the complications in Oklahoma pregnancies begin before the egg is even fertilized.
"And when you come into a pregnancy with already uncontrolled chronic health conditions, that makes it that much harder to take care of when the patient is pregnant," said Dr. Hawkins.
Some of the biggest factors include heart issues, high blood pressure, asthma and diabetes.
Access to maternal healthcare is also limited across the state, with only 28 counties containing a hospital suitable for childbirth.
Oklahoma is also one of the most underinsured states in the county. Prior to the expansion of SoonerCare, the state ranked second to last, just ahead of Texas.
"And so, when you have less patients insured, those patients are less likely to be going to get care prior to pregnancy," said Dr. Hawkins.
It’s too soon to see if the expansion of SoonerCare will impact maternal mortality. Early numbers from 2020 show a drop in mortality rates, more in line with the national average.
The Oklahoma Health Department says streamlining emergency response during delivery has helped.
"In the bigger hospitals the different units work together to come up with a policy so that everybody is clear this is what happens, and this is how it's going to happen. It's good information for the rural hospitals that don't have a lot of resources," said OSDH's Jill Nobles-Botkin Administrative Program Manager for Perinatal & Reproductive Health.
Another factor the state is focusing on is education. They want to alert families of the red flags before they are in the birthing room.
"We kind of emphasize care during the pregnancy and once a patient has given birth then there's really a drop off in how often we're seeing the patient," said OU's Dr. Pierce.
Experts say educating teens about contraception has shown benefits as well.
OSDH is aiming to make long-acting birth control more available. Along with providing mental health services to expectant mothers.