This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
- ACOG:
- American College of Obstetricians and Gynecologists
- AIM:
- Alliance for Innovation on Maternal Health
- CARE Act:
- Maternal Care Access and Reducing Emergencies Act
- CDC:
- Centers for Disease Control and Prevention
- CMQCC:
- California Maternal Quality Care Collaborative
- ICD-10:
- International Classification of Diseases, 10th Revision
- MMR:
- maternal mortality ratio
- MMRC:
- maternal mortality review committee
- MMRIA:
- Maternal Mortality Review Information Application
- MOMMA Act:
- Mothers and Offspring Mortality and Morbidity Awareness Act
- MOMS Act:
- Maternal and Obstetric Modernization of Services Act
- NCHS:
- National Center for Health Statistics
- PMSS:
- Pregnancy Mortality Surveillance System
- PQC:
- perinatal quality collaborative
- SMM:
- severe maternal morbidity
- WHO:
- World Health Organization
Abstract
The rising trend in pregnancy-related deaths during the past 2 decades in the United States stands out among other high-income countries where pregnancy-related deaths are declining. Cardiomyopathy and other cardiovascular conditions, hemorrhage, and other chronic medical conditions are all important causes of death. Unintentional death from violence, overdose, and self-harm are emerging causes that require medical and public health attention. Significant racial/ethnic inequities exist in pregnancy care with non-Hispanic black women incurring 3 to 4 times higher rates of pregnancy-related death than non-Hispanic white women. Varied terminology and lack of standardized methods for identifying maternal deaths in the United States have resulted in nuanced data collection and interpretation challenges. State maternal mortality review committees are important mechanisms for capturing and interpreting data on cause, timing, and preventability of maternal deaths. Importantly, a thorough standardized review of each maternal death leads to recommendations to prevent future pregnancy-associated deaths. Key interventions to improve maternal health outcomes include 1) integrating multidisciplinary care for women with high-risk comorbidities during preconception care, pregnancy, postpartum, and beyond; 2) addressing structural racism and the social determinants of health; 3) implementing hospital-wide safety bundles with team training and simulation; 4) providing patient education on early warning signs for medical complications of pregnancy; and 5) regionalizing maternal levels of care so that women with risk factors are supported when delivering at facilities with specialized care teams.
- Copyright © 2019 by the American Academy of Pediatrics
Individual Login
Institutional Login
You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.