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Maternal Mortality and Post-Delivery Warning Signs

Women in the United States remain at great risk of dying from pregnancy or childbirth-related complications, according to the Centers for Disease Control and Prevention (CDC). Based on 2021 data from the National Vital Statistics System, 1,205 women died in the United States due to a pregnancy or childbirth-related complication, an increase from 861 women in 2020 and 754 in 2019. Black women continue to lose their lives at substantially higher rates than White and Hispanic women. The maternal mortality rate for Non-Hispanic Black women was 69.9 per 100,000 live births compared to non-Hispanic White women at 26.6 and Hispanic women at 28.0.

Mental health conditions account for the greatest number of pregnancy-related deaths, according to a 2023 report by USA Facts. Other health conditions include cardiovascular, hemorrhage, sepsis/infection, embolism, and hypertensive disorders. Race and ethnicity have a direct correlation in pregnancy-related deaths. Non-Hispanic Black women succumb to cardiovascular conditions, while mental health issues are the main cause of pregnancy-related death for non-Hispanic White women. Hemorrhage is the leading cause of death among Asian women. Because this spectrum is so diverse, interventions developed to save the lives of pregnant and postpartum women should focus on the leading causes of death by race and ethnicity, as recommended by the CDC.

Post-delivery is an important time to make sure mom and baby are healthy. Education is vital to successfully reduce and prevent maternal mortality and morbidity. Education empowers Arkansas women, their family members, and their friends to recognize and report potentially life-threatening complications. New mothers should be encouraged to trust their instincts about their bodies.

Efforts to improve maternal health and reduce maternal mortality in Arkansas are numerous. In 2022, Arkansas became the 48th state to join the Alliance for Innovation on Maternal Health (AIM). A quality improvement initiative to support best practices that make birth safer, improve maternal health outcomes, and save lives. AIM develops multidisciplinary, clinical-condition-specific patient safety bundles to support best practices.

Arkansas launched its first state Perinatal Quality Collaborative (PQC) in 2023. State PQCs partner with hospitals, providers, patients, public health, and other stakeholders to provide opportunities for education, information, data sharing, and quality improvement support to achieve systems-level change and improve maternal outcomes. The current PQC initiative focuses on reducing primary cesarean delivery rates.

The Arkansas Maternal Mortality Review Committee (AMMRC), formed in 2020, helps to ensure the collection and accurate interpretation of maternal deaths in Arkansas. The committee performs comprehensive reviews of maternal deaths that occur during pregnancy or within one year of the end of a pregnancy. The AMMRC is tasked with developing clinical recommendations to improve maternal outcomes. AMMRC reports can be found on the Arkansas Department of Health website.

Educational materials regarding post-delivery warning signs are provided by AFMC and Arkansas Medicaid. If you are interested in these materials, please contact This email address is being protected from spambots. You need JavaScript enabled to view it.. Together, we can make a difference and decrease the number of families tragically affected by maternal mortality.

Kamilah's Story

Web Resources

Alliance for Innovation of Maternal Health
https://saferbirth.org/

America's Health Rankings: Health of Women and Children Report, 2022
https://www.americashealthrankings.org/learn/reports/2022-health-of-women-and-children-report

America’s Health Rankings: Maternity Practices Score in Arkansas, 2021
https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/mPINC_a/state/AR?edition-year=2021

Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN)
http://www.awhonn.org/
https://awhonn.org/education/hospital-products/post-birth-warning-signs-education-program/

Arkansas Department of Health Maternal Mortality Review Committee
https://www.healthy.arkansas.gov/programs-services/topics/arkansas-maternal-mortality-review-committee

California Maternal Quality Care Collaborative (CMQCC)
https://www.cmqcc.org/

The American College of Obstetricians and Gynecologists Women’s Health Physicians (ACOG)

(ACOG website works best on current web browsers Firefox, Chrome, and Edge)

Maternal Mortality
https://www.acog.org/search#q=maternal%20mortality&sort=relevancy&f:topic=[Maternal%20mortality]

Maternal Mortality in the United States
Recent Trends, Current Status, and Future Considerations
https://journals.lww.com/greenjournal/Fulltext/2021/05000/Maternal_Mortality_in_the_United_States__Recent.3.aspx

Centers for Disease Control (CDC)

Association of Mental Health Conditions, Recent Stressful Life Events, and Adverse Childhood Experiences with Postpartum Substance Use — Seven States, 2019–2020 Weekly/April 21, 2023 / 72(16);416–420 http://dx.doi.org/10.15585/mmwr.mm7216a1

Hear Her Campaign
https://www.cdc.gov/hearher/index.html

Maternal Mortality Rates in the United States, 2021 
https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm

Pregnancy Mortality Surveillance System
https://www.cdc.gov/prams/index.htm

Institute for Perinatal Quality Improvement (PQI)

https://www.perinatalqi.org/

https://www.perinatalqi.org/page/PPDischargeEdu

March of Dimes

https://www.marchofdimes.org/ResponseCDC2021MaternalMortalityReport

https://www.stoptheclot.org/spreadtheword/hospitalization/

MERCK For Mothers

http://merckformothers.com/

Review to Action

Working Together to Prevent Maternal Mortality
http://reviewtoaction.org/

University of Arkansas for Medical Sciences (UAMS) Institute for Digital Health & Innovation (IDHI) High-Risk Pregnancy Program

Patient Education
https://patientslearn.uams.edu/featured-topics/pregnancy-childbirth/

Post-delivery warning signs interactive video
http://learntelehealth.org/modules/Post%20Delivery%20Warning%20Signs/story_html5.html?lms=1

Provider Education, Programs, and Services
https://idhi.uams.edu/high-risk-pregnancy-program/healthcare-providers/community-outreach-education/

USA Facts
https://usafacts.org/articles/which-states-have-the-highest-maternal-mortality-rates/

Reviewed and Revised March 2024

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