Maternal Health : A Call to Action
by JUDY THERIOT , MD , CPE
In the year 2022 , a woman in the U . S . faces a higher risk of death during her pregnancy or within her first postpartum year than her mother did 25 years ago . 1 , 2 The World Health Organization ( WHO ) defines maternal mortality as : “ Death of a woman during pregnancy or within 42 days of the end of the pregnancy , from a pregnancy complication , a chain of events initiated by a pregnancy , or the aggravation of an unrelated condition by the physiologic effects of pregnancy .” 1 This definition excludes deaths that occur by accidental or incidental causes .
The Centers for Disease Control and Prevention ( CDC ) extends the WHO definition of maternal mortality to one year of life after delivery . In 2020 , the CDC reported the U . S . maternal mortality ( MM ) rate as 23.8 deaths per 100,000 live births . This is an increase from 20.1 in 2019 and 17.4 in 2018 . 1 Sadly , in 1987 , the U . S . had a much lower 7.2 deaths per 100,000 live births . 3 , 4 There are two additional ways we measure maternal mortality : pregnancy-related mortality and pregnancy-associated mortality . Pregnancy-related mortality is a death during pregnancy or within one year of the end of pregnancy from a pregnancy complication , a chain of events initiated by pregnancy or the aggravation of an unrelated condition by the physiologic effects of pregnancy . Pregnancy-associated mortality is a death while pregnant or within one year of the end of pregnancy from any cause . 2 While nearly half of all pregnancy-related deaths in the U . S . are reported to be caused by hemorrhage , cardiovascular and coronary conditions , cardiomyopathy or infection , it is estimated that more than 60 % of these deaths are preventable . 4 However , in Kentucky , only 16 % of our maternal deaths were determined to be pregnancy-related . 5
The U . S . is ranked 55th in the world - and last among wealthy countries - in maternal mortality . 6 In fact , the U . S . is the only country outside of Afghanistan and Sudan where the maternal mortality rate is rising . 6 How is that possible ? In 2020 , our country spent $ 4.1 trillion on health care-related goods and services , which was roughly 17 % of the nation ’ s gross domestic product . 7 While this is more than any other country , our maternal health indicators continue to decline . It is time to look at our health care system with a clinical eye to determine what life saving measures are needed to revive it .
The Kentucky Maternal Mortality Review Committee ( KY-
20 LOUISVILLE MEDICINE