Table 2.

Examples of Maternal Health Stakeholder Efforts to Reduce Maternal Mortality

Stakeholders24,25,44–57	Description
Legislators
The Preventing Maternal Deaths Acta	Reauthorizes through FY2023 for CDC to provide support to tribal, state, and local MMRCs.
The Improving Access to Maternity Care Acta	Requires HRSA to identify maternity care health professional target areas.
The Affordable Care Act	Provides support for the HRSA's Maternal, Infant, and Early Childhood Visitation Program.
The 21st Century Cures Act	Establishes Task Force on Research Specific to PRGLAC on safe and effective therapies.
The Senate Finance Committee Leaders	Call to submit data and findings on factors contributing to poor maternal health outcomes in the United States.
Public and private entities
CDC, CDC Foundation, AMCHP	Building U.S. capacity to review and prevent MM to remove barriers to fully functional MMRCs.
Merck for Mothers and Community Organizations	Safer Childbirth Cities Initiative to foster solutions led by local communities in helping cities to become safer and more equitable places to give birth.
Merck for Mothers and ACOG	Safe Motherhood Initiative to decrease MM by engaging health care providers and birthing facilities to develop and implement standard approaches for handling obstetric emergencies.
SMFM and ACOG	Joint consensus document that introduced a classification system for levels of maternal care.
IHS, ACOG, and AAP	Program to conduct-site visits and improve rural obstetrics care in the Indian health system.
CDC
ERASE MM	Supports agencies and organizations that coordinate and manage MMRCs.
Perinatal Quality Collaboratives	State or multistate networks of teams working to improve the quality of care for mothers and babies.
LOCATe	Helps states/jurisdictions create standardized assessments of levels of maternal and neonatal care.
HRSA SPRANS Program
AIM	Promotes the adoption and implementation of hospital-focused maternal safety bundles (evidence-based practices) for health care providers in birthing facilities and hospitals.
AIM–Community Care Initiative	Supports the development, adoption, and implementation of nonhospital maternal safety bundles for health care providers in community-based organizations and outpatient settings.
RMOMS	Develops, tests, and implements service models, with the goal of improving access to, and continuity of, maternal and obstetrics care in rural communities.
State MHI	Funds state-focused demonstration projects with three core functions: (1) establishing a state-focused Maternal Health Task Force, (2) improving state-level maternal health data and surveillance, and (3) promoting and implementing innovations in the health care delivery of maternal health care services.
Supporting MHI	Supports states, key stakeholders, and recipients of HRSA-administered awards.
NIH
Trans-NIH funding FY2018 ($302.6 million dollars)/FY2017 ($250 million dollars)	Funded maternal health projects addressing scientific gaps such as risk prediction, severe morbidity, optimal timing for delivery, maternal long-term outcomes, and data collection.
CCRWH	Provides valuable guidance, collaboration, and support to ORWH program goals.
ORWH/NICHD	Launched MMM web portal and MMM booklet; sponsored MMM workshops and meetings.
CMS
Rethinking Rural Health Initiative	Rural Health Strategy to have new health policies and initiatives positively impact rural communities.
Medicaid and CHIP	Scorecard to evaluate state progress on maternal health outcomes.
FDA
OMPT, CDER, and CBER	Issued Postapproval Pregnancy Safety Studies Guidance for Industry in 2019.
Office of Women's Health	Provides resources for consumers about food safety and medication use during pregnancy.
State/city
CMQCC (State of California and Stanford University School of Medicine)	Expanded Maternal Quality Improvement Toolkits in areas of substance exposure, sepsis, venous thromboembolism, and cardiovascular disease.
NYCDHMH	Five-year plan to improve MM disparity through city-wide hospital quality improvement network, comprehensive maternity care in NYC health system, enhancement of data quality, and timeliness and public awareness campaign.

AAP, American Academy of Pediatrics; ACOG, American College of Obstetricians and Gynecologists; AIM, Alliance for Innovation on Maternal Health; AMCHP, Association of Maternal and Child Health Programs; CBER, Center for Biologics Evaluation and Research; CCRWH, Coordinating Committee on Research on Women's Health; CDC, Centers for Disease Control and Prevention; CDER, Center for Drug Evaluation and Research; CHIP, Children's Health Insurance Program; CMQCC, California Maternal Quality Care Collaborative; CMS, Centers for Medicaid and Medicare; ERASE MM, Enhancing Reviews and Surveillance to Eliminate Maternal Mortality; FDA, Food and Drug Administration; FY, fiscal year; HRSA, Health Resources and Services Administration; IHS, Indian Health Service; LOCATe, Levels of Care Assessment Tool; MHI, Maternal Health Innovation; MM, maternal mortality; MMM, Maternal Morbidity and Mortality; MMRCs, Maternal Mortality Review Committees; NICHD, National Institute of Child Health and Human Development; NIH, National Institutes of Health; NYCDHMH, New York City Department of Health and Mental Hygiene; OMPT, Office of Medical Products and Tobacco; ORWH, Office of Research on Women's Health; PRGLAC, Research Specific to Pregnant Women and Lactating Women; RMOMS, Rural Maternity and Obstetrics Management Strategies; SMFM, Society for Maternal/Fetal Medicine; SPRANS, Special Projects for Regional and National Significance.

^aAmended the Public Health Service Act.