Important Facts for Maternal Mortality

Definition

'''Maternal mortality''' is a general term referring to the death of a woman during pregnancy or within a year of the end of pregnancy. Maternal deaths are also known as pregnancy-associated deaths. A '''pregnancy-related death''' is defined as the death of a woman during pregnancy or within one year of the end of pregnancy from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy. Pregnancy-related deaths are a subset of all pregnancy-associated (maternal) deaths. The '''pregnancy-related mortality ratio''' is the number of pregnancy-related deaths per 100,000 live births.

Numerator

Number of pregnancy-related deaths per year

Denominator

Total number of live births per year

Data Interpretation Issues

The CDC Pregnancy Mortality Surveillance System and the data presented here include pregnancy-related deaths during pregnancy and up to 365 days after the end of a pregnancy. The World Health Organization and Healthy People 2030 define a maternal death as the death of a woman while pregnant or within 42 days of the end of a pregnancy, from a pregnancy-related cause. Care should be taken to clarify whether data are based on a 42 day or 365 day time period and whether data refer to pregnancy-related deaths or pregnancy-associated (maternal) deaths.

Why Is This Important?

More than 1200 women died in the United States as a result of their pregnancy or delivery complications in 2021 (CDC). The death of a woman during pregnancy, delivery, or after delivery is a tragedy for her family and for society as a whole. Surveillance of maternal mortality identifies ways to improve one's health, health behaviors, and health care before, during, and after pregnancy. Surveillance also identifies gaps in the health care system, social services, health care access, and the quality of prenatal and postnatal care.

Other Objectives

Healthy People 2030 Objective MICH-04 aims to reduce the maternal mortality rate to 15.7 maternal deaths per 100,000 live births. This measure uses the definition of death while pregnant or within 42 days of being pregnant related to obstetric causes.

How Are We Doing?

The Utah pregnancy-related mortality ratio for 2019-2021 was 20.8 pregnancy-related deaths per 100,000 live births.

How Do We Compare With the U.S.?

Comparison between Utah and U.S. rates is complicated by differences in methodology when defining pregnancy-relatedness. As can be seen in the graph, the U.S. maternal mortality ratio has slowly increased. Reasons for this increase are not clear. Some of the increase is likely due to improved identification of maternal deaths. Other possible reasons may include an increase in chronic diseases that impact maternal health, including hypertension, diabetes, heart disease, and mental health conditions that put a person at higher risk of morbidity and mortality during pregnancy or in the year postpartum. Women may also experience more barriers to accessing affordable health care, which may increase health risks during and after pregnancy. More detailed information can be found at [https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm].

What Is Being Done?

The Utah Department of Health and Human Services conducts ongoing maternal mortality surveillance through the Perinatal Mortality Review program. Public education is provided on the importance of planning for pregnancy, preconception and interconception health, and recognition and treatment of maternal anxiety and depression. The Utah Women and Newborns Quality Collaborative (UWNQC) addresses issues of quality improvement in maternal and infant health care. The Hear Her campaign raises awareness of the urgent maternal warning signs during and after pregnancy to improve communication between patients, families, and healthcare providers. Utah has distributed more than 8,000 magnets with the urgent maternal warning signs to clinics, providers, and individuals attending community events.

Evidence-based Practices

Utah collaborates with the Alliance for Innovation on Maternal Health (AIM) to promote consistent and safe maternity care. The AIM has developed patient safety bundles, a package of evidence-based best practices for implementation in clinical settings. Safety bundles address the leading causes of maternal mortality and are designed to reduce maternal deaths related to obstetrical complications. In 2020 and 2021, Utah worked on the implementation of the Obstetric Care for Women with Opioid Use Disorder bundle. In 2020, a new website was launched to make it easier to find a mental health care provider with expertise in perinatal mental health. This resource can be found at [http://maternalmentalhealth.utah.gov/]. Thirty-four Utah hospitals earned the "Birthing-Friendly" designation from the Centers for Medicare and Medicaid Services (CMS) in 2023. This designation describes high-quality maternity care. Learn more about the "Birthing-Friendly" designation and see a map of the Utah "Birthing-Friendly" hospitals at [https://data.cms.gov/provider-data/birthing-friendly-hospitals-and-health-systems].