View the presentation and find out how to earn free continuing education. CDC scientists also provide technical assistance and guidance to support state and local Maternal Mortality Review Committees. These committees work to identify and review deaths of women who die as a result of pregnancy and develop recommendations to prevent future deaths. Capacity to Review and Prevent Maternal Deaths.
The site promotes the translation of findings into action and also serves as a resource for best practices in maternal mortality review. A key element of this work is the Maternal Mortality Review Information Application MMRIA External , a free, new data system for committee review information that, when used, provides stronger, more standardized and detailed data than what was previously available.
The Report from Maternal Mortality Review Committees: A View into Their Critical Role External proposes where we could go as a nation as more states are able to collaborate around a shared data framework and understand how the data can inform prevention activities. The Report from Nine Maternal Mortality Review Committees External shows that most pregnancy-related deaths are preventable and highlights key opportunities for prevention. Reproductive Health. Section Navigation. Facebook Twitter LinkedIn Syndicate.
What can women do to prevent a pregnancy-related death? What is CDC doing? Public Health Grand Rounds. According to the World Health Organization WHO , between and , maternal mortality rates decreased by an average of 2. And now the decline seems to have plateaued. When there is a high death rate, relatively simple interventions — raising awareness among women of the importance of seeking medical attention during pregnancy and childbirth, training local community health workers to spot signs of problems in labour — will bring fairly quick wins.
But moving the needle much further requires greater political will and more money, says Anneka Knutsson, chief of sexual and reproductive health at the UN population fund UNFPA. These relate to competent staff in place, and facilities that, in addition to safe normal deliveries, can provide blood transfusion, C-section or other types of assisted deliveries.
It requires more long-term and complex investments in the health system. This is one reason why the pace of decrease slows down. There are a number of reasons, and they are rooted in poverty, inequality and sexism. The majority of women die in poorer, rural areas, where healthcare services are often inadequate or inaccessible, and where there is a severe shortage of trained medical staff.
Women from such areas are less likely to give birth with a skilled health worker than wealthier women. Without professional help, women give birth alone or have to rely on female relatives or traditional birth attendants to support them, putting their lives in grave danger if complications arise. Women, particularly in rural areas, may live miles from any health centre, and might struggle to pay for the transport to get there if money is tight. Throughout pregnancy, women in poorer countries are much less likely to receive the eight antenatal appointments recommended by the WHO.
These appointments are crucial in identifying problems or underlying issues that could cause difficulties in childbirth — if a woman has malaria, for instance, or needs special support because she is HIV-positive.
Millions of women around the world are still unable to decide when or if they want to get married or have children. The largest proportion of women without access to modern contraception is in sub-Saharan Africa.
This means many women resort to unsafe, illegal abortions. Adolescent girls have a particularly high risk of death in childbirth. Last year the WHO found that complications in pregnancy and childbirth, together with unsafe abortion, were the biggest killers globally of girls aged 15 to The estimated maternal mortality rate was All developed countries did better: 4. Years of unreliable US maternal mortality data kept the problem under the radar.
In , the CDC tried to better identify pregnancy-related deaths by adding a box to check on death certificates if the deceased was pregnant or postpartum. Data on the causes of death during childbirth or postpartum are also incomplete. It is the job of the 35 state and local maternal mortality review committees to analyze redacted patient records to learn what went wrong and recommend ways to address contributing factors.
The initiatives ranged from addressing pregnancy-related complications such as depression, domestic violence, and cardiovascular disease to helping clinicians better manage hypertension, hemorrhage, and other obstetric emergencies. Too few maternal deaths occur in most states each year to yield meaningful interventions to prevent those deaths, argues Steven Clark, MD, professor of obstetrics and gynecology at Baylor College of Medicine. Hemorrhage, cardiovascular and coronary conditions, cardiomyopathy, or infection caused nearly half of the deaths, but the leading causes of death varied by race.
Preeclampsia and eclampsia, and embolism were the leading causes of death for non-Hispanic black women, while mental health problems led to more deaths in non-Hispanic white women. Medical errors, ineffective treatments, and lack of care coordination by clinicians and hospitals are major causes of preventable deaths, according to the report. The toolkits include evidence-based practices and recommendations for how to implement them.
More importantly, the CMQCC mobilizes outreach efforts that help clinicians follow best practices and overcome barriers, including hospital cultures that get in the way.
For example, the obstetric hemorrhage bundle requires hospitals to have emergency carts containing drugs and equipment needed to immediately respond to a mother who is hemorrhaging.
A checklist on the cart describes how to recognize and manage hemorrhage. Making childbirth safer in hospitals may be less daunting than remedying a lack of prenatal care or unraveling the causes of postpartum deaths.
Another problem: Mothers will bring their newborns for a well-baby visit, but many skip their own postpartum 6-week visit where depression and other potential life-threatening problems may be diagnosed.
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