Preventing Maternal Deaths in New York State through Maternal Mortality Review
Abstract
Maternal mortality (MM) and morbidity are key indicators of the health of a society and serve as measures for the overall health and well-being of a community.¿Maternal deaths are devastating events with prolonged effects on partners, children, families and health care teams. A recent report ranked New York State (NYS) 30th¿in the nation for the rate of MM . Although this¿represents¿an improvement over¿the ranking of 46th¿in 2010,¿NYS’ 2014-2016¿MM rate of¿19.6 deaths per 100,000 live births¿was¿1.8 times¿the Healthy People 2020 target of 11.4 deaths per 100,000 live births.¿Between 2014 and 2016, racial disparities remained significant in NYS with the MM rate for black¿women (51.6 deaths per 100,000 live births) more than three¿times that for white women (15.9 deaths per 100,000 live births).¿
NYS has two functioning maternal mortality review committees that collaborate to conduct comprehensive reviews of factors leading to MM, which inform interventions focused on reducing the incidence of these deaths and other maternal health disparities. The Maternal Mortality and Morbidity Committee (M3RC) led by New York City Department of Health and Mental Hygiene (DOHMH) reviews cases that occur within their jurisdiction, while the Maternal Mortality Review Committee (MMRC) led by NYS Department of Health (DOH) reviews all rest of state maternal deaths. Receipt of this grant award will enhance the work already undertaken by DOH and DOHMH by coordinating these two Committees in working jointly to review all maternal deaths across the state, eliminate preventable maternal deaths and complications of pregnancy, and the racial and ethnic inequities in these outcomes.
The objectives of both Committees are: 1) to identify and review all maternal deaths in NYS within two years of the date of death; and 2) to use the Committees’ data-driven findings to inform prevention strategies. Short-term outcomes of these MM reviews will include: timely, accurate and standardized information available about deaths of women during pregnancy and the year after the end of pregnancy, including identifying opportunities for prevention; increased awareness of the findings and recommendations among the public, clinicians and policy makers; and implementation of data-driven recommendations (e.g. evidence-based practices, patient education by providers and screenings) at NYS birthing hospitals. Intermediate outcomes will include the widespread adoption of patient safety bundles and/or policies that reflect the highest standards of care at NYS birthing facilities, including the treatment of respectful care in childbirth. Lastly, the long-term outcome of the Committees’ processes will be a reduction in maternal complications of pregnancy, including a decrease in racial disparities.
The grant will also support NYS DOH and NYC DOH to share data regularly and collaboratively with CDC through the Maternal Mortality Review Information Application (MMRIA) data system. With the data sharing requirement, the DOH and DOHMH will further identify opportunities for process and data quality improvements by monitoring MMRIA data routinely. With the analyses of the Committees’ results in NYS and the analyses of aggregated MMRIA data performed by CDC, NYS will better identify opportunities for prevention.
