Since 1999, the reported maternal mortality data in California show a persistent 3-4x gap between Black mothers and mothers from all other racial groups. Also, maternal mortality rates nearly doubled in California between 1999 and 2006. CMQCC was founded in 2006 at Stanford University School of Medicine together with the State of California. Since CMQCC’s inception, California’s maternal mortality rate has declined by 55 percent while the national maternal mortality rate continued to rise. The expectation was that widespread adoption of CMQCC’s clinical safety bundles would reduce the gap in the number of maternal deaths among Black women. However, the difference in outcomes for Black mothers compared with all other racial groups has persisted.
Further analysis revealed that clinical safety bundles and social support interventions done in isolation, without an integrated approach, did not produce the desired outcomes. Thus, CMQCC’s Birth Equity Collaborative presents an opportunity to develop QI tools to promptly evaluate and transform birth care, experiences, and outcomes through the integration of clinical and sociocultural interventions and community-hospital partnerships
- Data shows that even in the absence of risk factors such as age over 35 years, lack of health insurance, inadequate or no prenatal care, and less than high school education, the U.S. system of health care is not protecting Black mothers and birthing people from experiencing higher numbers of deaths or life-threatening complications during pregnancy and childbirth.
- Increasing evidence points to racism within and across multiple levels, and not race, as a key cause of these birth disparities.
- Data also show variations in the quality of care and outcomes across hospitals in California, highlighting opportunities for advancing equity in quality improvement.
The success that California has achieved in the significant reduction in maternal mortality rates is a direct reflection of the outcomes that are possible when collaboration exists around a patient safety concern. The existing data and literature evidence has provided the impetus to formalize an action plan to address this racial equity issue. With our California Birth Equity Collaborative pilot, CMQCC aims to transform birth care for Black mothers and birthing people together with Black women-led CBOs and our hospital partners.