Troubling news: Maternal mortality is on the rise

OBG Management. 2007 October;19(10):10-14

October 1, 2007|ObGyn

Why has a decades-long trend reversed? And what can we do to keep our patients safe?

TABLE

What can be done to reduce maternal mortality?
Actions for the health system to consider

Make effective contraception more widely available¹ Make community-based general medicine and mental health services also more widely available for women considering pregnancy² Undertake regular simulation exercises on labor and delivery; such exercises should focus on serious obstetric catastrophes, such as postpartum hemorrhage, and provide a means of assessing and improving the performance of hospital systems³ Establish regional strategies for consulting on and transferring sick pregnant and postpartum women⁴ Create formal case identification and management programs for women who have severe preeclampsia⁵ Develop standard consultation guidelines for women with serious chronic diseases who are contemplating pregnancy and those at increased risk of adverse pregnancy outcome⁶ Reduce the use of cesarean delivery when possible—especially elective cesareans^7,8 Reduce the rate of twin and triplet pregnancy Improve prevention and treatment of deep venous thrombosis in the peripartum period
References

Lifesaving attention to black patients is needed

It’s a recurring observation that Hispanic and white (non-Hispanic) women have a consistently lower maternal death rate than black women do (see the accompanying figure). This observation likely does not reflect any difference in case finding or in the definition of maternal mortality across states. There is a higher rate of obstetric problems, including preeclampsia, among black women that may account for a percentage of the difference, but the contribution of those problems to a racial discrepancy would be small.¹

The fact that black women have a markedly increased rate of maternal death for uncertain reasons establishes a clear need for focused research—the goal being to develop targeted interventions to reduce maternal death in this racial group.

Reference

Among black women, a disproportionately high rate of maternal death
Source: From Table 34 on page 103 of Miniño AM, Heron MP, Murphy SL, Kochanek KD. Deaths: final data for 2004. Natl Vital Stat Rep. 2007;55(19):1–120.

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References

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