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Georgia lawmakers approved a requirement for medical examiners to investigate the cause of death of a pregnant woman or a woman who dies within one year of giving birth.

The law will go into effect July 1, unless vetoed by Gov. Brian Kemp.

The law's sponsor, Sen. Dean Burke, R-Bainbridge, said he is trying to lower the number of maternal deaths in the state.

Georgia's average maternal mortality rate between 2015 and 2017 — the most recent data available — was 25.1 per 100,000 live births. That was significantly higher than the national average for the same period: 17.1, according to the Centers for Disease Control and Prevention.

Black women in Georgia are at even higher risk, as they are 2.3 times more likely to die from pregnancy-related causes than non-Hispanic white women, according to the state Department of Public Health.

Those numbers don't tell the whole story, though. A Maternal Mortality Committee was established in 2014 to tackle the issue, but has since run into obstacles because, in many cases, the cause of death is not known or listed in official records.

"It's hard to fix a problem when we don't know what the cause is," Burke said.

Under the new law, a pathologist at a perinatal center would be required to perform autopsies on the bodies of pregnant and postpartum women unless the cause of death was obvious. If the cause of death were obvious — for example, massive trauma from a car accident — the pathologist would still investigate, but not require an autopsy.

Tina Marie Marsden is a patient advocate and member of the Metro Atlanta American Heart Association Advocacy Team who testified before lawmakers about her own close call during pregnancy.

Marsden said when she was four months pregnant with her second child, she was diagnosed with postpartum cardiomyopathy, a rare heart condition.

"Early warning signs during and after pregnancy were missed in my case," said Marsden. "Pregnancy related complications including high blood pressure, blood clots, cardiovascular disease, stroke and other heart problems like cardiomyopathy may not surface until weeks or months after delivery."

"I did eventually need a mechanical heart pump or LVAD [left ventricular assist device] to sustain life," she added.

Bethany Sherrer, the director of government relations and general counsel at the Medical Association of Georgia, shared her support for the law during the same meeting.

"This is a very important issue to our membership: tackling the issues surrounding maternal mortality and ensuring that postpartum women have access to the care that they need and that we have the data that we need in order to tackle those issues," she said.

Elizabeth Mosely, a clinical assistant professor at Georgia State University who specializes in maternal and child health, said in an interview that while the new law is a significant step, she does not believe that it will lower the rate of maternal mortality in Georgia.

"Reducing maternal mortality — and disparities — takes broad investment in access to health care and social resources across the life course, not only when someone is pregnant," she said. "We need Medicaid expansion across our state and robust solutions for the negative social determinants of health including poverty and racism."

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