PRB

What are the challenges to measuring maternal mortality in the United States? And what do the data show about our progress against maternal death?

On July 22, PRB’s Mark Mather moderated a discussion among leading researchers on the nuances in maternal mortality data in the United States—and potential policy recommendations. The briefing at the U.S. Capitol was hosted by the Population Association of America (PAA), in cooperation with PRB, the American College of Obstetricians and Gynecologists, the American Statistical Association, the Association of Population Centers, the March of Dimes, and the Society for Research in Child Development.

Mather shared PRB’s work as part of a national campaign to raise awareness of the maternal health crisis facing Black women, who data show are 3.5 times more likely to die from pregnancy or childbirth complications. After a PRB research brief caught the attention of TANK Worldwide, the marketing company connected PRB with the nonprofit Dr. Shalon’s Maternal Action Project to create the “My Last Lullabye” video, which was covered by media outlets like NPR and earned a CLIO Health award.

“At PRB we report on statistics, rates, patterns, and trends, but this video is a good reminder that there are people behind all these numbers,” Mather said.

Robert N. Anderson of the National Center for Health Statistics discussed how the National Vital Statistics System (NVSS) defines and classifies maternal mortality, and how the addition of the “pregnancy checkbox” to death certificates changed how states record maternal deaths—and adds complexity to national statistics. (See his presentation.)

Data from both the NVSS and the Center for Disease Control and Prevention’s Pregnancy Mortality Surveillance System show that maternal mortality in the United States has increased over time, explained Amanda Jean Stevenson of the University of Colorado Boulder. “Pregnancy and birth have been getting deadlier by either measure,” Stevenson said. The United States also has higher maternal death rates than peer countries, including Japan and the United Kingdom, and faces severe racial disparities in pregnancy outcomes, with Black and American Indian/Alaska Native women significantly more likely to die, evidence shows. (See her presentation.)

Alecia J. McGregor of Harvard University described the leading factors behind these racial disparities, including environmental stress and weathering, disparate access to care, and the closure of obstetric units across the country, especially in counties with a high percentage of Black women of reproductive age. Policies that support midwifery and doula care and increase Medicaid reimbursement for obstetric services are among potential solutions, McGregor added. (See her presentation.)

Note: PRB’s work on this project was supported under a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).