CA-PAMR (Maternal Mortality Review)

Begun in 2006, the California Pregnancy-Associated Mortality Review (CA-PAMR) is co-convened by the Maternal, Child and Adolescent Health Division of the California Department of Public Health, the Public Health Institute and CMQCC. This work has produced three reports, several peer-reviewed journal articles and provided the rationale for maternal quality toolkits that transformed the improvement opportunities into implementation efforts to better care for pregnant and postpartum women who experience obstetric hemorrhage, hypertensive disorders of pregnancy, venous thromboembolism, sepsis, and cardiovascular disease.  

In 2024, there are three reviews in process, with volunteer committees composed of clinicians and community members selected for their expertise, representativeness, and commitment to eliminating preventable maternal mortality and racial inequities.

Pregnancy-Associated Mortality Surveillance System (PMSS), 2008-current

A small subset of reviewers from the 2002-2007 CA-PAMR report reviewed > 500 cases of deaths occurring to women within one year of pregnancy to determine pregnancy-relatedness and cause of death. The project produced a report on pregnancy-related deaths that occurred between 2008-2016. The CA-PMSS committee team is reviewing deaths in near real-time.

Findings up to 2021 from this review are available at the California pregnancy-related mortality dashboard from the California Department of Public Health, Maternal, Child and Adolescent Health Division. Here you will find state-level data for 2009-2021 at a glance, obtain more details for indicator subcategories, as well as download data for your own analyses.

Southern California Pregnancy-Associated Review Committee, 2019-ongoing

Funded by grants from the CDC-ERASE program, the SoCAL PARC covers maternal deaths in Los Angeles, Orange, Riverside, San Bernardino, San Diego and Imperial counties from 2019 – current. The project began reviewing cases in December 2020 and includes a new data collection tool which incorporates social determinants of health perspectives and the role that discrimination/bias contributes to maternal deaths. Learn more about how the CDC supports maternal mortality review committees (MMRCs) at the Review to Action website.

Central Valley Pregnancy-Associated Review Committee, 2024

California is launching a California Pregnancy-Associated Review Committee (CA-PARC)  in the Central Valley counties of Butte, Colusa, Glenn, Fresno, Kern, Kings, Madera, Merced, Placer, San Joaquin, Sacramento, Shasta, Stanislaus, Sutter, Tehama, Tulare, Yolo and Yuba.  

Applications to serve on the Central Valley CA-PARC can be found here and more information about the Committee can be found here.

Active reviews have ended, and data analysis is underway: 

Focused Statewide Review of Obstetric Hemorrhage Deaths, 2014-2018

This review examined cause of death and identified quality improvement opportunities among the cases of women who died from hemorrhage. As of 5/13/2022, the committee reviews and data analysis are complete. A manuscript to be submitted to peer-reviewed journal is undergoing approvals at CDPH. 

Focused Statewide Review of Maternal Deaths due to COVID-19, 2020-2022

This review examined maternal deaths from COVID which occurred in 2020 and 2022. Data analysis is underway, and the team plans to disseminate the findings in a timely way.

Funding Acknowledgement 

CA-PAMR is supported by federal Title V Maternal and Child Health block grant from the California Maternal, Child and Adolescent Health Division of the California Department of Public Health.