SR 63 — INVESTIGATE MATERNAL MORTALITY

*LRB10108448ALS53522r* SR006310100SR0063 Enrolled LRB101 08448 ALS 53522 r SENATE RESOLUTION WHEREAS,NO. African American women in the United States experience maternal-related deaths at three to four times the rate of non-Hispanic white women, according to the Mothers and Offspring Mortality and Morbidity Awareness Act, introduced by U.S.

Representative63 RobinWHEREAS, KellyAn estimated 700 to 900 women now die as a result of Illinoispregnancy inand Maychildbirth-related causes, and over 60 percent of 2018;the pregnancy-related deaths in the United States are preventable;

and WHEREAS, InIllinois Illinois,had Non-Hispanicmore blackthan women150,000 arebirths sixin times2016 aswith likely to die of a pregnancy-related condition as non-Hispanic white women, and 72 percentpregnancy-associated of the pregnancy-related deaths and 93985 percentinfant ofdeaths; violent pregnancy-related deaths were deemed preventable by review committees;

and WHEREAS, The72 Unitedpercent Statesof hasthe notpregnancy-related beendeaths ableand to93 submitpercent aof formalviolent-pregnancy-related maternaldeaths mortalitywere ratedeemed topreventable internationalin dataIllinois repositoriesby sincereview 2007;committees;

and WHEREAS, African American women in orderthe toUnited beStates ableexperience tomaternal-related calculatedeaths aat formalthree maternalto mortalityfour rate,times maternalthe mortality-relatedrate dataof mustnon-Hispanic bewhite streamlinedwomen, ataccording to the StateMothers leveland Offspring Mortality and extrapolatedMorbidity toAwareness theAct, federalintroduced level;by U.S.

Representative Robin Kelly of Illinois in May 2018;

and WHEREAS, Non-Hispanic black women are six times as likely to die of a pregnancy-related condition as non-Hispanic white women in Illinois, according to the Illinois Maternal Morbidity and Mortality Report;

and WHEREAS, The United States has not been able to submit a 10100SR0063 Enrolled -2- LRB101 08448 ALS 53522 r formal maternal mortality rate to international data repositories since 2007, and, in order to be able to calculate a formal maternal mortality rate, maternal mortality-related data must be streamlined at the State level and extrapolated to the federal level;

and SR0063WHEREAS, -2-Among LRB101the 08448top ALScommon 53522causes rof WHEREAS,pregnancy-related Hemorrhage,deaths infection,in andIllinois hypertensive disorders of pregnancy are amonghemorrhage, theinfection, topand commonhypertensive causesdisorders of pregnancy-relatedpregnancy; deaths in Illinois;

and WHEREAS, The State of California has established Maternal Mortality Review Committees to determine the most prevalent causes of maternal mortality and has recorded and shared data with providers and researchers, who have developed and implemented safety bundles and care protocols related to preeclampsia, maternal hemorrhage, and other prevalent causes of maternal mortality;

and WHEREAS, The Illinois Department of Public Health currently works with the Maternal Mortality Review Committee and the Maternal Mortality Review Committee for Violent deathsDeaths to review cases of maternal death and to develop statewide 10100SR0063 Enrolled -3- LRB101 08448 ALS 53522 r recommendations to prevent future maternal deaths;

and WHEREAS, In the State of California, state-based maternal quality collaborative organizations have formed obstetrical protocols, tool kits, and other resources to improve system care and response as they relate to maternal complications and warning signs for conditions,conditions includingsuch as maternal hemorrhage, hypertension, and preeclampsia;

and WHEREAS, Illinois has begun developing protocols and SR0063 -3- LRB101 08448 ALS 53522 r resources to address common causes of maternal mortality in the State, such as implementing new training material regarding hemorrhages through the Obstetric Hemorrhage Education Project (OBHEP) in 2016;

and WHEREAS, The CDC reports that more than half of all maternal deaths occur in the immediate postpartum period, which is between 42 days to a full year after delivery;

and WHEREAS, RacismResearch ishas deeplyshown ingrainedthat, inrelative theto Unitedwhite States10100SR0063 systems,Enrolled including-4- inLRB101 health08448 careALS delivery53522 systemsr betweenpatients, black patients andare providers,less oftenlikely resultingto inbe disparategiven treatmentpain ofmedications, pain,and, irreverencewhen topain culturalmedication normsis withgiven, respectthey toreceive health,lower andquantities; dismissiveness;

however,and theWHEREAS, providerA pool2015 isstudy notfrom primedJAMA withPediatrics manyfound peoplethat ofblack color,children norwith areappendicitis providerswere consistentlyless requiredlikely to undergoreceive implicitpain bias,medication culturalthan competency,their orwhite empathycounterparts; training on a consistent, on-going basis;

and WHEREAS, ThereA havestudy beenexamining effortsdisparities toin address implicit bias and cultural competency at the federaltriaging, level by awarding SR0063 -4- LRB101 08448 ALS 53522 r cooperative agreements for the establishment or supportgiving ofa regionaldegree centers of excellenceurgency addressingto, implicitpediatric biasemergency anddepartment culturalpatients competencyconcluded inthat patient-providerblack, interactionsHispanic, forand theNative purposeAmerican ofpatients enhancingreceived andlower improvingacuity howtriage healthscores carethan professionalswhites arewhen educatedpresenting insubjective implicitcomplaints, biassuch andas deliveringbreathing culturallydifficulty competentor healthabdominal care;pain;

and WHEREAS, TheResearchers Statehave ofalso Illinoisdocumented recognizesan theassociation importancebetween ofrace investigatingand increased mortality from stroke, and addressingothers maternalhave mortalityfound issuesthat inminority thepatients State;are less likely to receive thrombolytics than white patients;

therefore,and beWHEREAS, itA RESOLVED,study BYin THEthe SENATEProceedings OFof THEthe ONENational HUNDREDAcademy FIRSTof GENERALSciences ASSEMBLYcontributes OFbias THEin STATEpain OFassessment ILLINOIS,and thatmanagement weof urgepatients partially to the Generalfact Assemblythat toabout continuehalf toof investigatemedical students and identifyresidents areasbelieved ininaccurate whichbiological thedifferences Statebetween canblack improveand withwhite respectpeople, toincluding thethat preventionblack ofpeople maternalhave mortality,less especiallysensitive amongnerve vulnerableendings populations.or that a black 10100SR0063 Enrolled -5- LRB101 08448 ALS 53522 r person's blood coagulates more quickly, as well as other unconscious biases;

and WHEREAS, Biases in patient assessment and treatment affect the level of care for pregnant women, particularly women of color;

and WHEREAS, The provider pool is not primed with many people of color, nor are providers consistently required to undergo implicit bias, cultural competency, or empathy training on a consistent, on-going basis;

and WHEREAS, Studies have also shown that women are generally less likely to be diagnosed with diseases, such as heart disease, and are less likely to receive aggressive treatment for pain management and certain diseases than men;

and WHEREAS, There have been efforts to address implicit bias and cultural competency at the federal level by awarding cooperative agreements for the establishment or support of regional centers of excellence addressing implicit bias and cultural competency in patient-provider interactions for the purpose of enhancing and improving how health care professionals are educated in implicit bias and delivering culturally competent health care;

therefore, be it 10100SR0063 Enrolled -6- LRB101 08448 ALS 53522 r RESOLVED BY THE SENATE OF THE ONE HUNDRED FIRST GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that the State of Illinois recognizes the importance of investigating and addressing maternal mortality issues in the State;

and be it further RESOLVED, That we urge the General Assembly to investigate and identify areas in which the State can improve with respect to the prevention of maternal mortality, especially among vulnerable populations.