According to a new report by the US Centers for Disease Control and Prevention, four out of every five pregnancy-related deaths in the U.S. are preventable. For the women who died during pregnancy, during delivery or up to a year postpartum, more than 84% of deaths could have been avoided with “reasonable changes” by health care providers, the community the patient or others.

The CDC report results were drawn from 2017-2019 data from Maternal Mortality Review Committees. The analysis included 1,018 pregnancy-related deaths reported in 36 states. Among them, about 22% occurred during pregnancy, 25% occurred within 7 days of delivery and 53% occurred between 7 days to 1 year postpartum.

The leading underlying causes of death during pregnancy or the postpartum period were:

• Mental health conditions, including suicide and overdose/poisoning related to substance use disorder (23%)
• Excessive bleeding (14%)
• Cardiac and coronary conditions (13%)
• Infection (9%)
• Thrombotic embolism (9%)
• Cardiomyopathy (9%)
• Hypertensive disorders of pregnancy (7%)

Reducing preventable pregnancy-related deaths

In recent years, national policies and quality-improvement initiatives have been introduced to combat some of the key drivers of maternal mortality. The new CDC report is valuable for practitioners focused on key quality initiatives.

“What stands out the most is that 53% of the deaths are occurring postpartum,” said Dr. Mark Simon, Ob Hospitalist Group (OBHG) Chief Medical Officer. “The breakdown also tells us we need to focus on cardiovascular and mental health.”

OBHG works with hospitals nationwide to drive change across the labor and delivery unit. As a data-driven organization, OBHG leverages its depth of experience and data to provide robust data benchmarking and reporting to support continuous improvement for hospital partners.

Our teams collaborate with our hospital partners to implement national clinical protocols, including hypertension and postpartum hemorrhage. They also develop customized action plans for the unique needs and opportunities at each facility.

“As new data and reports emerge, our efforts at OBHG continue to evolve as we remain focused on processes that will improve outcomes,” said Dr. Simon. “Our new Maternal Mental Health Committee is one example. This committee is developing new screening and treatment tools our hospital partners can use to focus on maternal mental health, one of the concerning areas highlighted within the CDC report.”

OBHG clinicians closely collaborate with emergency room colleagues at our hospital partner sites. “The new report highlights the opportunity to further deepen the partnerships between our OB hospitalists and their emergency room colleagues. With so many deaths occurring after delivery, women reporting to the emergency room with postpartum concerns is an important area of opportunity,” said Dr. Simon.

How Ob Hospitalist Group helps address maternal mortality

• Ensuring all obstetrical patients receive immediate, unbiased care through all stages of pregnancy by an experienced clinician at the hospital 24/7
• Assisting mothers who do not have an obstetrician and patients who may not have received prenatal care
• Focusing on data and results
• Partnering with hospitals to implement national clinical protocols for maternity care
• Implementing postpartum protocols and educating providers about hemorrhage and hypertension signs and risk
• Elevating the care for all patients on the unit
• Partnering closely with the Preeclampsia Foundation on hypertensive disorders of pregnancy initiatives
• Closely collaborating with emergency room colleagues
• Focusing on maternal mental health screenings and treatments
• Addressing inherent biases and inequities of care

If you’d like to learn more about how our clinicians are addressing maternal mortality, let us know.