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DOH report: pregnancy‑related deaths rose in 2021–22; panel urges expanded home visiting, equity‑focused supports
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Summary
Washington’s Maternal Mortality Review Panel found a peak in pregnancy‑related mortality in 2021 and concluded most pregnancy‑related deaths in 2021–22 were preventable; authors recommended strengthening care access, community supports (including home visiting), and culturally responsive services.
Debs Gardner, maternal mortality review coordinator at the Washington State Department of Health, told the Home Visiting Advisory Committee that the panel’s 2021–2022 review found a sharp rise in pregnancy‑related deaths and a high proportion judged preventable. "Any maternal death is unacceptable," Gardner said, and the panel submitted a legislative report in December with prioritized recommendations.
The Department of Health report covers 2021–22 and cumulative findings through 2014–22. Annie McHugh, maternal mortality epidemiologist, presented the data, saying Washington’s pregnancy‑related mortality rate peaked at 33.4 deaths per 100,000 live births in 2021 and was 27.6 in 2022. For 2021–22 the panel identified 107 pregnancy‑associated deaths; 51 were determined pregnancy‑related and the panel judged 42 of those preventable. "Eighty‑two percent is very high," McHugh said, noting that the finding also points to opportunities for prevention.
The presenters emphasized disparities: non‑Hispanic American Indian and Alaska Native people experienced the highest pregnancy‑related mortality rate (about 7.3 times the rate for non‑Hispanic white people). McHugh also identified top contributing causes in 2021–22: accidental overdose (notably involving fentanyl), COVID‑19, suicide, cardiovascular conditions including peripartum cardiomyopathy, and thrombotic embolism.
To address those patterns the report organizes recommendations under three priorities: improving health‑care quality and access (including better care coordination and expanded substance‑use disorder treatment that is family‑friendly and low‑barrier); strengthening community support services (including home visiting, doula and peer supports, and wrap‑around services); and providing equitable, culturally responsive care (including tribal‑led and community‑aligned programs, trauma‑informed training, and anti‑bias efforts). Debs Gardner said 12 recommendations are aimed at the legislature and dozens more are targeted to agencies, healthcare systems, and community partners.
The report also calls for maintaining postpartum coverage and strengthening rural access and workforce supports. Committee members raised questions about rural provider recruitment, tribal partnerships, and practical steps for aligning home visiting models with the report’s recommendations. The presentation ended with DOH offering to provide tailored or regional briefings to support local planning.
The panel’s data and recommendations will inform legislative and agency actions; DOH asked the committee to consider which recommendations HVAC should prioritize for the coming fiscal year.
