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June 14, 2019

Preventing Maternal Deaths Act Headed to Trump's Desk

Mary Caffrey
In the past, data-gathering on pregnancy-related deaths has been irregular and review committees have not always addressed prevention.
A bill aimed at reducing pregnancy-related deaths in the United States is headed to President Donald Trump’s desk, after passing both the House of Representatives and the Senate in unanimous votes last week.

The Preventing Maternal Deaths Act would establish and support Maternal Mortality Review Committees at the state level; these groups would be required to review every pregnancy-related death and develop recommendations to prevent future deaths. It also provides $12 million a year in new funds for 5 years for states to fund these committees.

Maternal mortality has been rising in the United States, and disparities by race have alarmed obstetricians and public health officials. Between 700 and 900 women in the United States die each year from pregnancy-related causes, and the CDC states that 60% of these deaths are preventable. Data gathering in the past has been irregular, and review committees that operate now often do so without funding and do not address how deaths can be prevented.

According to CDC, pregnancy-related deaths rose from 7.2 per 100,000 in 1987 to 18 per 100,000 in 2014. In 2014, the rate was 12.4 pregnancy-related deaths among white women, 40 deaths among black women, and 17.8 deaths among women of other races.

Causes of death, as listed by the CDC, are:
  • Cardiovascular diseases, 15.2%
  • Non-cardiovascular diseases, 14.7%
  • Infection or sepsis, 12.8%
  • Hemorrhage, 11.5%
  • Cardiomyopathy, 10.3%
  • Thrombotic pulmonary embolism, 9.1%
  • Cerebrovascular accidents, 7.4%
  • Hypertensive disorders of pregnancy, 6.8%
  • Amniotic fluid embolism, 5.5%
  • Anesthesia complications, 0.3%
Rising rates of diabetes and obesity, lack of access to care, especially in rural areas; and increased age of mothers at their first pregnancy are contributing factors to the mortality rates, but they do not fully explain them, experts say.

The legislation has been a top priority of the American College of Obstetricians and Gynecologists (ACOG), which praised the House for passing the bill on December 11, 2018. The Senate passed it December 13, 2018.

“The passage of the Preventing Maternal Deaths Act has been a long-held goal for ACOG and is a crucial step to reversing our country’s rising maternal mortality rate. No more pregnant and postpartum women should die from preventable causes,” said Lisa Hollier, MD, MPH, ACOG president, in a statement.

“The Preventing Maternal Deaths Act authorizes federal funding for multidisciplinary entities known as maternal mortality review committees (MMRCs) that review individual cases of maternal death. MMRCs are key to developing locally relevant strategies to eliminate maternal mortality,” she said.

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