The Pulitzer Board announced that ProPublica’s partnership with NPR was a finalist in the Explanatory Reporting category for “Lost Mothers,” an illuminating series on the maternal mortality crisis in the United States. ProPublica Illinois and The Chicago Tribune were also named Pulitzer finalists for Local Reporting for their “Tax Divide” series. The two designations were ProPublica’s eighth and ninth Pulitzer finalists in 10 years of publishing.
Led by ProPublica reporter Nina Martin, engagement reporter Adriana Gallardo and NPR special correspondent Renee Montagne, ”Lost Mothers” began with a disquieting trend: For the past two decades, as maternal mortality has declined in other affluent countries, U.S. rates of maternal mortality were rising. The U.S. has the highest rate of mothers who die during pregnancy, childbirth and postpartum in the developed world, with 700 to 900 American women dying from complications each year. Additionally, every year more than 50,000 American women nearly die during pregnancy and childbirth.
Soon into their reporting, an intriguing question arose: Where were the mothers? The usual journalism tools, such as Nexis and Google, turned up surprisingly few names, and obituaries rarely mention the cause of death. To identify these mothers, the reporters scoured crowdfunding sites like GoFundMe and YouCaring, verifying names with obituaries and public posts on Facebook and Twitter. They also published a callout, asking affected families to tell their stories. More than 4,700 people responded, including 4,000 women who said they had almost died themselves. These efforts helped the reporters create a first-of-its kind database of mothers who died from pregnancy-related complications, eventually identifying more than 160 maternal deaths in 2016 alone.
The comprehensive body of work featured an intimate narrative about Lauren Bloomstein, a neonatal nurse who died in childbirth in the hospital where she worked. Bloomstein died because her preeclampsia, a type of high blood pressure that only occurs in pregnancy or postpartum, wasn’t diagnosed in time. Her story reflects a health care system with no standard protocol for what to do in obstetric emergencies, and one with a greater emphasis on the baby’s health than on the mother’s.
Another story analyzed African-American women’s disproportionate rates of maternal mortality, focusing on the experience of Shalon Irving, a CDC researcher who studied racial health disparities. She died three weeks after giving birth. The feature explored how stress from social inequalities, as well as unconscious biases throughout the medical system, can lead to poor maternal outcomes for black women.
ProPublica reporter Annie Waldman used patient discharge data to document racial disparities at the hospital level, and freelancer Kate Womersley showed a striking contrast between the British approach to maternal care that has reduced rates of maternal mortality and the American health care system’s abdication of its responsibility to track deaths and learn from them. Freelancer Katherine Ellison, and NYU journalism graduate students Emma Cillekens and Alessandra Freita, also contributed to the series.
“Lost Mothers” spurred significant impact. Citing the series, state and local lawmakers around the country have adopted a flurry of bills aimed at reforming how maternal deaths are identified and investigated. Indiana and Oregon passed laws creating maternal mortality review committees to scrutinize deaths and near-deaths among expectant and new mothers, and to make policy recommendations to improve maternal health. Similar bills are pending in Washington, D.C., Pennsylvania, Connecticut, Maryland and New Jersey. The reporting has also saved lives: At least three women used “Lost Mothers” stories to self-diagnose life-threatening symptoms that their providers overlooked.
“When it comes to maternal deaths in the United States, the lack of transparency and awareness around the problem is one of its major contributors,” said ProPublica’s managing editor Robin Fields, who directed the reporting with senior editor Daniel Golden. “By shifting the conversation from private to public, the comprehensive reporting of ‘Lost Mothers’ has pushed hospitals, regulators and policymakers to more aggressively address preventable maternal complications and deaths. This groundbreaking series also gave voice to impacted families, allowing them, at last and at a minimum, to have the deaths of their loved ones recognized.”