Critical Steps to Reverse Rising U.S. Maternal Mortality Rates

Last week on my flight from our nation’s capital to the Texas capital, I heard the amazing news! Congress took a critical step in combating the U.S. maternal mortality crisis by passing the Preventing Maternal Deaths Act. The bill is now on its way to the president’s desk for enactment.

This achievement follows nearly a decade of ACOG advocacy and active engagement by obstetricians—gynecologist, our partner organizations, and members of Congress. We all worked together consistently and tirelessly on this bipartisan legislation to ensure that no more mothers die from preventable causes before, during, or after pregnancy. It is an important step, and by no means is it the last that we will take to end preventable maternal deaths.

Why This Bill Matters

The Preventing Maternal Deaths Act will provide federal funding to create or expand maternal mortality review committees (MMRCs) in every state. MMRCs bring together multidisciplinary teams made up of local obstetricians—gynecologists, nurses, social workers, and other community stakeholders to review the causes of maternal deaths and find local solutions to prevent them.

While we have all heard and read the appalling statistics of rising maternal mortality rates, what drives us all to end this crisis goes beyond the numbers. It is the lived experiences we have with our patients and their families and with our mothers, aunts, sisters, and daughters. This issue touches every one of us.

My motivation for ending maternal mortality was kick-started early in my career. I witnessed the death of a healthy new mother who lost consciousness on arriving to labor and delivery. Like so many of these deaths, there is no one person to blame. There is a complex set of contributing factors that cause maternal deaths. MMRCs are a vital step to understanding the causes of maternal mortality and how we can prevent similar cases in the future. Supporting the work of MMRCs has been a key initiative of mine as ACOG president and is part of a larger ACOG effort to make every facility in the United States a safer place to deliver.

Implementing AIM at the Hospital and State Level

The Preventing Maternal Deaths Act is only one piece of the puzzle. Through the Alliance for Innovation on Maternal Health (AIM), ACOG leads a national partnership of provider, public health, and advocacy organizations dedicated to reducing maternal complications and deaths. With plans to expand to 35 states next year, AIM teaches hospitals how to prepare for, recognize, and respond to emergency situations. AIM maternal safety bundles (sets of best practices) support doctors, nurses, and hospitals with tools to be fully prepared. The bundles include things such as

• Checklists and team training
• Risk screening to identify women who may need additional attention
• Processes to recognize potential problems early
• Workflows that help team members respond quickly and consistently in circumstances where you might only have a few minutes to save a mother and child

AIM has already seen promising improvements in maternal complication rates from the first four states that joined the initiative. Its success relies on state teams comprised of state health departments, health associations, perinatal collaboratives, provider groups, and hospitals all working together to implement consistent maternity care practices and gather and report data on outcomes and process measures. The data allow them to measure progress and determine which practices are working.

There Is Still More We Need to Do

While positive steps are being made, real progress requires fundamental changes in women’s health care — not just from hospitals and providers but also from policy makers at every level. ACOG has been working to make our voices heard on this vital issue, but we need your help because our work is far from over.

Stay tuned as we continue our work with the U.S. Congress and in statehouses across the country next year. I look forward to continuing to stand shoulder to shoulder with you, my colleagues and friends, as we work together to improve women’s health and make childbirth safer for all.