Sixty-eight Missouri women died while pregnant or within a year of pregnancy in 2018, and mental health and substance abuse were two of the top contributing factors.
That finding of the state Department of Health and Senior Services' latest annual pregnancy-associated mortality review is discouraging but not necessarily surprising.
On Tuesday, we reported on the new review, which aims to help the state understand the causes and contributing factors of maternal mortality so we can work to prevent them in the future.
The report found 82 percent of pregnancy-related deaths were preventable.
While it's sad that deaths weren't prevented, it's encouraging that similar situations can be prevented in the future.
This prevention will need to be a team effort, with patients and their physicians leading the effort.
Screening failures were listed as a big contributing factor. Health providers, the report said, must perform depression/anxiety screenings and substance use disorder screenings on every patient at every interaction. This must be done not just through the pregnancy, but for a year afterward.
Then, doctors need to make referrals to mental health professionals, social workers and treatment programs when appropriate.
But these steps by physicians don't do any good unless patients follow the protocols. This problem of "adherence" was listed as the third most common contributing factor in the deaths.
Also not surprising, two of the top recommendations were requests for more money from the Missouri Legislature.
The report said the Legislature should fund a statewide perinatal quality collaborative and provide immediate funding to establish a statewide perinatal consult center to provide telehealth services for substance use disorder and mental health conditions.
It's easy to suggest throwing money at the problem. But money is tight, and that doesn't always help.
Some of the recommendations continue to be addressed, such as the need for seat belt campaigns. (About 28 percent of pregnancy-associated deaths occurred in motor vehicle crashes.)
Also, as the report suggests, physicians may need to be better at screening and referring pregnant patients to specialists.
But we also believe personal responsibility plays a part, just as the health of baby and mother starts with her and her spouse working as a team.