Strides have been made in education, research and clinical care to reduce maternal deaths.
Oct 1, 2019
Major strides have been made to improve maternal safety in the United States, but these achievements will have to be sustained and expanded to successfully reduce maternal mortality, according to a report by experts at NewYork-Presbyterian, Columbia University Irving Medical Center and other organizations.
The five-year report card to assess progress on maternal morbidity and mortality in the U.S. was recently published in the American Journal of Obstetrics and Gynecology.
The report, “Putting the ‘M’ back in maternal-fetal medicine: A five-year report card on a collaborative effort to address maternal morbidity and mortality in the U.S.,” spans 2012-2017 and concludes that major educational, research and clinical strides have been made to improve maternal safety.
“Collaborating with colleagues from across the country to improve maternal health has been a privilege,” said lead author Dr. Mary D’Alton, chair of the Department of Obstetrics and Gynecology at NewYork-Presbyterian/Columbia University Irving Medical Center and the Willard C. Rappleye Professor of Obstetrics & Gynecology at Columbia University Vagelos College of Physicians and Surgeons. “While this report details a lot of critical work that has been accomplished, there is still so much to do together to reduce harm to moms before, during and after childbirth.”
Each year about 700 women die of pregnancy- and childbirth-related causes in the U.S. and more than 50,000 experience severe complications, according to the U.S. Centers for Disease Control and Prevention.
In 2012, the first “Putting the ‘M’ Back in Maternal-Fetal Medicine” session was held at the Society for Maternal-Fetal Medicine’s Annual Meeting to address rising rates of maternal deaths and severe complications, or “near misses.” The meeting identified urgent needs to enhance education and training in maternal care for maternal fetal-medicine fellows, who are high-risk pregnancy experts; improve the medical care and management of pregnant women across the country; and address critical research gaps in maternal medicine.
Since then, several initiatives have been put in place. For example, maternal-fetal medicine fellows are now required to do rotations on the critical care and labor and delivery units, and more obstetrician-gynecologists are undergoing critical care and simulation training to manage life-threatening scenarios, the report says. In addition, a number of safety initiatives have been developed to improve maternal care, and the number of states with maternal mortality review committees has risen. The lessons learned from these in-depth reviews of maternal deaths are invaluable in understanding the problem, improving maternal safety and eliminating preventable maternal deaths, the report notes.
But while major strides have been made, much still needs to be done to successfully reduce preventable deaths and harm, the report concludes, and these initiatives will have to be sustained and expanded over the coming years. For example, while guidelines for identifying and treating the leading preventable causes of maternal death have been developed and implemented in some places, like New York State and California, implementing them in all of the nation’s 3,000 hospitals that provide obstetric services “represents a formidable challenge,” the report says.
Read about how Dr. Mary D’Alton is working collaboratively to reduce maternal deaths and severe complications here.