Next Steps to Reduce Maternal Morbidity and Mortality in the USA

Sarah J Kilpatrick


Women's Health. 2015;11(2):193-199. 

In This Article

Abstract and Introduction


Maternal mortality is rising in the USA. The pregnancy-related maternal mortality ratio increased from 10/100,000 to 17/100,000 live births from the 1990s to 2012. A large proportion of maternal deaths are preventable. This review highlights a national approach to reduce maternal death and morbidity and discusses multiple efforts to reduce maternal morbidity, death and improve obstetric safety. These efforts include communication and collaboration between all stake holders involved in perinatal health, creation of national bundles addressing key maternal care areas such as hemorrhage management, call for all obstetric hospitals to review and analyze all cases of severe maternal morbidity, and access to contraception. Implementation of interventions based on these efforts is a national imperative to improve obstetric safety.


Maternal mortality in the USA, after a dramatic fall from 900s/100,000 live births in the early 1900s, largely due to the advent of antibiotics, plateaued at 8–10/100,000 from 1980 until the late 1990s at which point maternal mortality rose.[1–4] Worldwide between 1990 and 2013 maternal mortality decreased in nearly every country, except the USA, where it increased by 1.7%.[5] In a country that spends more on healthcare dollars than most countries this rise is particularly unacceptable. Understanding the causes of these deaths as well as the preventable factors has become a national imperative.