With Mother's Day just around the corner, BIO sat down with Dr. Mary-Ann Etiebet, Executive Director of Merck for Mothers, for a discussion about how Merck helping address maternal health needs in the United States and in countries impacted by COVID-19.
BIO: What is Merck for Mothers? What kinds of programs do you invest in, generally and specifically for COVID-19?
Dr. Etiebet: Merck for Mothers is Merck’s $500 million initiative to ensure women have healthier pregnancies and safer deliveries. Applying Merck’s business and scientific resources, we collaborate with partners to improve the health and well-being of women during pregnancy, childbirth, and the postpartum period.
Our focus is on supporting and testing new models that expand women’s access to affordable, quality maternity care with the potential to be scaled and sustained. For example, we’ve pursued the development of digital innovations that can unlock new ways to improve maternal health outcomes. We’ve also advocated for and supported the role of local community organizations and private providers, who play a critical role in addressing pregnant women’s needs both in the U.S. and globally.
With the COVID-19 crisis, we’ve announced a $3 million commitment to help health systems better meet the needs of pregnant women before, during and following delivery. We’ve seen the pandemic already exacerbate some of the greatest barriers in maternal health, including access to quality care; and both women and their providers are seeking the most up-to-date information and guidelines to best support pregnancy and childbirth. To help address these maternal health needs, we will be directing investments to efforts both in the United States and globally in countries impacted by COVID-19.
BIO: Why is maternal death still a problem in 2020? Can you talk about the scale of the problem and why it continues to grow, particularly in the United States?
Dr. Etiebet: Every two minutes, a woman dies from complications related to pregnancy and childbirth. This is a global issue, with certain countries like India and Nigeria facing the greatest burden. In the United States in particular, we’ve actually seen the maternal mortality rate increase over the last decade and have the greatest impact on certain populations: a black woman is three to four times more likely to die than a white woman.
There is no one cause, or solution, for all these deaths. Some of the leading causes include postpartum hemorrhage, eclampsia, or chronic health conditions that might have worsened during pregnancy. Most importantly, the majority of these deaths are preventable.
BIO: How can we prevent maternal death?
Dr. Etiebet: Maternal mortality, both in the United States and globally, is a multi-factoral problem that requires multi-sectoral solutions. There is no silver bullet, whether related to the needs exacerbated by the COVID-19 pandemic or otherwise.
A critical step – globally, country specific and even locally – is understanding why these deaths happen in the first place. Understanding the data, and then turning these insights into actions, are the foundation. There’s been a significant amount of progress here, but it’s something we need to keep advocating for, updating, and assessing.
It’s also essential that providers, women, as well as their larger care network and support system, have access to the latest information, resources and guidelines. It seems quite practical, but it’s something that needs to continue to be scaled and replicated. When organizations are able to implement evidence-based tools, and women are able to know what to look out for and ask for, it makes a significant difference for everyone.
Lastly, and perhaps most importantly, solutions need to be designed based on women’s experiences. A maternal death is not one single moment, it’s about a woman’s access to quality care and information before she even gets pregnant. It’s about strengthening the entire health system around her, and understanding the realities she is facing in her community.
With all this in mind, all types of resources and solutions are needed – from the government to the private sector, academia, non-profits, and more – to continue to support women and their maternal health needs, collaborate, and ultimately have the greatest impact for the long-haul.
BIO: What do pregnant women need to know about COVID-19? Do they or their newborns face any greater risk during this pandemic? How can we ensure safe delivery and hospital stays for mothers and babies right now?
Dr. Etiebet: Childbirth cannot wait for this pandemic to ease; and the concerns raised by both women and their providers are very real and build on larger issues we see in maternal health.
There is a risk that the negative impacts of the COVID-19 pandemic will be differentially experienced if we aren’t intentional in how to connect every woman with access to quality care during their pregnancy journey. The pandemic reinforces the collective responsibility to target efforts and support so that we do not inadvertently exacerbate the inequities that currently exist in the system. When the system is stressed, more women will fall through the cracks.
We’re also seeing the growing role local communities and community-based services, as well as digital efforts, to help alleviate current circumstances. Given the pandemic, more health care providers are setting up virtual appointments with their patients, sharing educational webinars for expectant mothers and connecting mothers to online care groups.
Both today and in the future, a network of care providers - both in person and digitally - working in partnership with a pregnant woman and meeting them wherever they are will be essential to improve maternal care outcomes and reduce the number of preventable maternal deaths.
BIO: To end on a positive note, what are some of the biggest successes of Merck for Mothers?
Dr. Etiebet: Since 2011, we’ve helped more than ten million women have healthier pregnancies and safer deliveries. We believe better maternal health care is a pathway to a lifetime of good health - vital for a woman’s wellbeing and prosperity – and so much more.
We have programs in nearly fifty countries, and are continuing to work to ensure that the entire health system is strengthened as a result of these investments. From when we first started, our mission has always been to help create a world where no woman has to die giving life – and we believe the efforts underway are helping to make a difference for today, as well as generations to come.