Severe Maternal Morbidity

Severe Maternal Morbidity in United States

United States

The Centers for Disease Control and Prevention (CDC) has found that the prevalence of severe maternal morbidity is steadily increasing. Maternal morbidity is any outcome of labor or delivery that leads to short- or long-term health consequences among women, such as hypertension, diabetes during pregnancy, anemia and depression. Severe maternal morbidity includes more serious and potentially life-threatening events and outcomes, such as hemorrhage, eclampsia, blood transfusions or hysterectomy. Additionally, racial disparities in maternal morbidity persist.

The rate of severe maternal morbidity is higher among:

• All non-white racial and ethnic minority mothers compared with non-Hispanic white mothers; non-Hispanic Black mothers have the highest rate. 
• Mothers ages 35 and older compared with younger mothers. 
• Mothers with preexisting conditions, multiple births (twins, triplets, etc.) or a prior cesarean section. 
• Mothers who have never given birth and those who have given birth three or more times.

The White House has a blueprint for addressing the maternal health crisis that identifies goals and actions for agencies across the federal government to improve health equity. Their goals include increasing access to and coverage of maternal health services and strengthening economic and social support. 

Other strategies to prevent maternal morbidity include: 

• Organizing meetings for communication and collaboration among stakeholders. 
• Creating multidisciplinary and national guidelines.
• Reviewing and analyzing cases of severe maternal morbidity to determine areas of improvement.
• Increasing research efforts for a better understanding of maternal morbidity. 
• Emphasizing American Board of Obstetrics and Gynecology Maternal-Fetal Medicine Fellowship training among health care providers.

There are also a number of individual behaviors that promote a healthy pregnancy, including eating a safe and healthy diet, maintaining a healthy weight and getting regular dental checkups.

Healthy People 2030 has an objective to reduce severe maternal complications identified during delivery hospitalizations.

Gray, Kristen E., Erin R. Wallace, Kailey R. Nelson, Susan D. Reed, and Melissa A. Schiff. “Population-Based Study of Risk Factors for Severe Maternal Morbidity: Risk Factors for Severe Maternal Morbidity.” Paediatric and Perinatal Epidemiology 26, no. 6 (November 2012): 506–14. https://doi.org/10.1111/ppe.12011.

Howell, Elizabeth A. “Reducing Disparities in Severe Maternal Morbidity and Mortality.” Clinical Obstetrics and Gynecology 61, no. 2 (June 2018): 387–99. https://doi.org/10.1097/GRF.0000000000000349.

Kilpatrick, Sarah J. “Next Steps to Reduce Maternal Morbidity and Mortality in the USA.” Women’s Health 11, no. 2 (March 1, 2015): 193–99. https://doi.org/10.2217/WHE.14.80.

Leonard, Stephanie A., Elliott K. Main, Karen A. Scott, Jochen Profit, and Suzan L. Carmichael. “Racial and Ethnic Disparities in Severe Maternal Morbidity Prevalence and Trends.” Annals of Epidemiology 33 (May 2019): 30–36. https://doi.org/10.1016/j.annepidem.2019.02.007.