Kansas bill would broaden scope of investigation into maternal deaths

TOPEKA — For 41 years, Rita Williams Thompson’s daughter Charmaine battled through health difficulties because of what her mother described as negligent behavior by doctors throughout her pregnancy.

On three separate occasions, Williams Thompson told doctors something was wrong. She noted swelling in her feet, legs and hands, but the only response she got was to watch her salt intake. Williams Thompson ended up requiring an emergency C-section. Charmaine Williams was born four months early, weighing just one pound and 6 ounces.

Attending doctors told Williams Thompson that her daughter would not survive the night. Her daughter surpassed those expectations, living for 41 years before she died last year, but Williams Thompson said the doctor’s negligence put her life at risk and subjected her daughter to countless medical issues.

“There is no reason that my daughter Charmaine should have been born as early as she was,” said Williams Thompson in a letter written to the Senate Public Health and Welfare Committee chaired by Sen. Richard Hilderbrand, R-Galena. “If her story can help prevent any other premature births where expectant mothers have shared health concerns that were not validated or addressed by their doctors, then all she had endured in her life will be a benefit to many.”

Williams Thompson backed Senate Bill 42, which would expand the investigative duties of the health secretary in cases of maternal deaths, to ensure other mothers will have their medical concerns taken seriously. Advocates of the bill say this could save the lives of many Kansas mothers and their children.

In cases of maternal death, the bill requires the secretary of the Kansas Department of Health and Environment to fill out a form that includes a section on racial inequalities in health care, work with providers to promote maternal health during and after pregnancy and help health care facilities implement performance measures.

The state health secretary would also be required to establish an external community review panel that includes stakeholders of color, has access to publicly available data and externally reviews Black maternal death cases.

Heather Braum, the health policy adviser at Kansas Action for Children, said the bill’s provisions would reduce racial disparities in Kansas maternal deaths. According to the 2020 Kansas Maternal Mortality Review, racial and ethnic minorities made up about two-thirds of deaths determined to be pregnancy-related.

“In order to determine why these deaths associated with pregnancy occur, we must learn much more about the conditions of the mom’s life prior to death or severe maternal morbidity,” Braum said. “Knowing which social determinants of health factors could be contributing to these situations will help drive health care system changes and could lead to additional policy changes.”

Sharla Smith, director of the Kansas Birth Equity Network, noted the economic impact of maternal deaths. She said the estimated total maternal morbidity costs for all U.S. births in 2019 was $32.3 billion.

“No Kansan woman should die of a preventable death, and no Kansan should have to worry about dying of childbirth,” Smith said. “However, we cannot ensure that Kansan women survive pregnancy if we do not thoroughly examine the deaths and causes of deaths.”

Written testimony provided to the committee by KDHE raised concerns about potential violations in the vital statistics act and conflicts with confidentiality provisions. The department argued the current system of gathering and assessing maternal mortality data is adequate and in line with best practices established by the Centers for Disease Control and Prevention.

While current investigation practices and collaborative efforts have improved the situation, Sapphire Garcia-Lies, president and founder of Wichita Birth Justice Society, said the number of pregnancy-related deaths that were preventable, estimated at 92.3%, shows the need for further insights.

“Kansas families need your help. They need to know that we are using every tool at our disposal to prevent maternal deaths in our state,” Garcia-Lies said. “As Kansans, we must unite behind the shared belief that every baby deserves a strong start in life with a healthy, thriving mother.”