The United States now ranks 60th in the world, and worst among developed nations, in maternal mortality. Each year more than 600 women in the United States die from pregnancy and childbirth, and more than 50,000 suffer a life-threatening complication (“severe maternal morbidity”).
The maternal mortality ratio doubled between 1987 and 2011, from 7.2 to 17.8 deaths per 100,000 live births; severe maternal morbidity doubled between 1998 and 2011, from 74 to 163 per 10,000 delivery hospitalizations. There continues to be large and persistent disparities; for example, a black woman is more than three times as likely to die from pregnancy and childbirth as a white woman, a gap we haven’t been able to close in decades.
Dr. Michael C. Lu
The Maternal and Child Health Bureau is partnering with the American College of Obstetricians and Gynecologists and the Council on Patient Safety in Women’s Health Care (“the Council”) in launching a new national campaign to reduce maternal mortality and severe morbidity in the United States. The goal of the campaign is to prevent 100,000 maternal deaths or severe morbidities in the next 5 years by doing three things:
• Improving women’s health before pregnancy, with a focus on promoting preventive services including preconception, interconception, and postpartum care.
• Reducing primary cesarean deliveries, with an immediate focus on developing an evidence-based patient safety bundle to reduce low-risk, nulliparous, term, spontaneous, and vertex (NTSV) cesarean deliveries.
• Improving the quality and safety of maternity care, with a focus on implementing patient safety bundles to reduce mortality and morbidity associated with hemorrhage, preeclampsia, and thromboembolism in every birthing hospital and facility across the country in the next 3 years.
Safety bundles are small, straightforward sets of evidence-based practices that, when performed collectively and reliably, have improved patient outcomes. Several states have begun to pilot these safety bundles. In New York, ob.gyn. leaders such as Dr. Mary D’Alton are working with more than 1,000 health care providers to implement these safety bundles in 118 hospitals throughout the state.
In California, under the leadership of Dr. Elliott Main and other clinical and public health leaders, and in partnership with California Department of Public Health, the maternal mortality ratio decreased from a high of 16.9 in 2006 to 6.2 deaths per 100,000 live births in 2012.
If we are going to move the needle on maternal mortality and severe morbidity in this country, we are going to need an ob.gyn. champion in every hospital and every state. To learn more about the campaign and to find out how you can help, please visit the Council’s website at safehealthcareforeverywoman.org and click on the AIM Program.
Dr. Lu is the director of the Maternal and Child Health Bureau at the Health Resources and Services Administration, and an associate professor of obstetrics, gynecology, and public health at the University of California, Los Angeles.