Why the Increase?
Introduction
The causes of the increase in maternal mortality seen recently in California and a number of other states is still being examined. Some investigators point to the recent improvements in identification of maternal deaths and collection of maternal death data. Others point to significant changes in population characteristics of pregnant women making them more at risk for morbidity and mortality. Lastly, most investigators allow that administrative and population characteristics changes account for only some of the increase seen but that a significant portion of the increase may be due to clinical factors under the control of the health care system. Herein lies one of the major opportunities for CMQCC.
Based on the findings of CA-PAMR, maternal mortality seems to be rising for four reasons:
1. Better data collection may account for about 30% of the rise
2. More pregnant women have chronic health conditions such as obesity, hypertension or heart disease that contribute to worse outcomes
3. Social factors, such as poverty, reduced education, exposure to chronic stress, are present for many pregnant women
4. Several quality improvement opportunities were identified for maternity care professionals and hospitals that provide obstetrical care
