Amy Ushry, RN, MPH, on Maternal Morbidity and Mortality in the United States
In May 2019, the Centers for Disease Control and Prevention (CDC) issued a report on maternal morbidity and mortality in the United States, stating that as many as 3 in 5 pregnancy-related deaths are preventable.1
Amy Ushry, RN, MPH, spoke about rates of maternal morbidity and mortality and ongoing endeavors to reduce them at the Nurse Practitioners for Women’s Health 22nd Annual Premier Women’s Healthcare Conference in Savannah, Georgia.2 Consultant360 discussed this topic further with her.
Amy Ushry, RN, MPH, is a Nurse Program Manager of Special Projects at Alliance for Innovation on Maternal Health at the American College of Obstetricians and Gynecologists.
Consultant360: Could you discuss the current state of maternal morbidity and mortality in the US, especially in light of the CDC’s report stating that as many as 3 in 5 pregnancy-related deaths are preventable?
Amy Ushry: At a time when 157 out of 183 countries in the world report decreasing rates of maternal mortality, the United States continues to see an increase. African American and American Indian/Alaska
Native women are 2- to 3-times more likely to experience a pregnancy-related death than
white women. In addition, for every maternal death in the United States, there are 100 women who experience severe maternal morbidity, or a “near miss.” The fact that as many as 3 in 5 pregnancy-related deaths are preventable shows that more can and must be done to reduce maternal mortality in this country.
C360: What quality improvement efforts have been made so far to reduce maternal morbidity and mortality in the United States, and what can be done to continue progress in this area?
Amy Ushry: Federal investment in maternal mortality review committees has been an important quality improvement effort to improve states’ capacity to review trends in maternal mortality and morbidity. Data and reports from review committees help Perinatal Quality Collaboratives and other groups focus their efforts on addressing the leading causes of death in their states. Investment in Perinatal Quality Collaboratives has also been vital, as these multidisciplinary partnerships of providers, payers, patients, community-based organizations, and other stakeholders work together to support hospitals and clinical sites in implementing data-driven quality improvement.
In addition, the Alliance for Innovation on Maternal Health (AIM), which is funded by the federal Health Resources and Services Administration’s Maternal and Child Health Bureau and comprised of more than 25 multidisciplinary organizations, seeks to reduce maternal deaths and severe maternal morbidity through a number of different strategies. Among these strategies is the development of AIM Patient Safety Bundles, which provide evidence-based recommendations to improve outcomes for major causes of maternal death, such as postpartum hemorrhage, severe hypertension, and maternal venous thromboembolism. AIM facilitates collaboration between the 27 states who are currently implementing patient safety bundles and provides support for their quality improvement efforts. In addition to federal and state investments, there are countless community-based organizations who are not only doing advocacy work, but also providing hands-on support to women across the country.
Collectively, these are some examples of quality improvement efforts in the United States. I believe that to move the needle, we must continue investing in these existing efforts while also looking to develop new strategies for reducing maternal mortality and morbidity.
C360: What key takeaways do you hope attendees left your session with?
Amy Ushry: I hope that attendees left the session understanding the rise of maternal mortality and morbidity in the United States, and how African American and American Indian/Alaska Native women are disproportionately impacted. I also hope that attendees understand that, to improve maternal health outcomes, providers must listen to women and deliver evidence-based, respectful care with “Every mom. Every time.” Finally, attendees should feel more knowledgeable about the AIM Program’s work and empowered to become an active participant in efforts to reduce maternal mortality and morbidity.
- Petersen EE, Davis NL, Goodman D, et al. Vital Signs: pregnancy-related deaths, United States, 2011–2015, and strategies for prevention, 13 states, 2013–2017 [published online May 7, 2019]. MMWR. http://dx.doi.org/10.15585/mmwr.mm6818e1.
- Ushry A. Maternal mortality: Alliance for innovation in maternal health. Presented at: Nurse Practitioners for Women’s Health 22nd Annual Premier Women’s Healthcare Conference; October 16-19, 2019; Savannah, GA.