Tennessee is grappling with a maternal mortality crisis, consistently ranking among the states with the highest rates of pregnancy-related deaths. Now, a state senator is spearheading a series of legislative efforts aimed at improving maternal health outcomes, addressing both systemic gaps in care and the immediate needs of families experiencing loss.
Data from the Centers for Disease Control and Prevention revealed that Tennessee held the highest maternal mortality rate in the country from 2018 to 2022, with 166 deaths resulting in a rate of 41.1 per 100,000 live births. While the Tennessee Department of Health’s most recent annual report, covering 2023, showed a 15% decrease in the pregnancy-related mortality rate – falling from 65 to 55 per 100,000 live births – the numbers remain alarmingly high, and a significant proportion of these deaths are considered preventable. The 2023 report found that 74% of the 34 pregnancy-related deaths were preventable.
Addressing Emergency Access and Rural Healthcare Disparities
Senator London Lamar (D-Memphis) is the driving force behind the proposed legislation. One key bill seeks to prevent emergency departments from turning away women actively in labor. This initiative was spurred, in part, by widely circulated reports of women being denied care in other states. As Senator Lamar explained, “We want to make sure that doesn’t happen here in Tennessee.”
The concern is particularly acute in rural areas of Tennessee, where maternity wards are closing at a higher rate than in most other states. Limited access to obstetric care in these regions creates significant barriers for pregnant individuals, potentially delaying critical interventions and contributing to adverse outcomes.
Supporting Families Experiencing Stillbirth
Recognizing the profound emotional and financial burden associated with stillbirth, another bill proposed by Senator Lamar would utilize federal Title V funding to assist families with burial costs. This aims to ensure that all families, regardless of socioeconomic status, can afford to bury their children with dignity and receive support during an incredibly difficult time. “We want to ensure women, regardless of your socioeconomic background, are able to bury their children with dignity and support during such an unexpected time,” Senator Lamar stated.
Expanding Access to Certified Nurse Midwives
A third legislative proposal focuses on expanding access to care by initiating a study into allowing certified nurse midwives (CNMs) to practice independently. Currently, 31 states and Washington D.C. Permit independent practice for CNMs. Senator Lamar believes that leveraging the skills of CNMs could help address gaps in maternity care, particularly in underserved areas.
“With such gaps in the rural area around maternity care, being able to have nurse midwives fill in those gaps in lieu of OBGYNs is something that’s positive in filling the need of the lack of services in our rural areas and some of our urban enclaves,” she explained. CNMs provide a range of services, including prenatal care, labor and delivery support, and postpartum care, and can play a vital role in improving access to comprehensive maternity care.
A Preventable Crisis
The urgency of these legislative efforts is underscored by the fact that the majority of pregnancy-related deaths in Tennessee are considered preventable. This highlights the need for systemic improvements in healthcare access, quality of care, and provider training. The bills are currently navigating the committee process and require approval from both the House and Senate to become law.
The ongoing debate and legislative action reflect a growing awareness of the maternal health crisis in Tennessee and a commitment to finding solutions that will protect the lives and well-being of pregnant individuals and their families. The focus on preventative measures, expanded access to care, and support for families experiencing loss represents a multi-faceted approach to addressing this complex public health challenge.
