Box 2.
Global and Domestic Strategies to Reduce Maternal Mortality in the United States
| World Health Organization: Strategic Framework Toward EPMM | ||
| Guiding principles for EPMM | ||
| Empower women, girls, and communities. | ||
| Protect and support the mother–baby dyad. | ||
| Ensure country ownership; leadership; and supportive legal, technical, and financial frameworks. | ||
| Apply a human rights framework to ensure that high-quality reproductive, maternal, and newborn health care is available, accessible, and acceptable to all who need it. | ||
| Crosscutting actions for EPMM | ||
| Improve metrics, measurement systems, and data quality to ensure that all maternal and newborn deaths are counted. | ||
| Allocate adequate resources and effective health care financing. | ||
| Five strategic objectives for EPMM | ||
| Address inequities in access to and quality of sexual, reproductive, maternal, and newborn health care. | ||
| Ensure universal health coverage for comprehensive sexual, reproductive, maternal, and newborn health care. | ||
| Address all causes of maternal mortality, reproductive and maternal morbidities, and related disabilities. | ||
| Strengthen health systems to respond to the needs and priorities of women and girls. | ||
| Ensure accountability to improve quality of care and equity. | ||
| Health Resources and Services Administration International Summit: Key Findings in Areas Where Action Could Contribute to Decreased Maternal Mortality | ||
| Access: Improve access to patient-centered, comprehensive care for women before, during, and after pregnancy, especially in rural and underserved areas. | ||
| Safety: Improve quality of maternity services through efforts, such as the utilization of safety protocols in all birthing facilities. | ||
| Workforce: Provide continuity of care before, during, and after pregnancies by increasing the types and distribution of health care providers. | ||
| Life Course Model: Provide continuous team-based support and use a life course model of care for women before, during, and after pregnancies. | ||
| Data: Improve the quality and availability of national surveillance and survey data, research, and common terminology and definitions. | ||
| Review Committees: Improve quality and consistency of Maternal Mortality Review Committees through collaborations and technical assistance with U.S. states. | ||
| Partnerships: Engage in opportunities for productive collaborations with multiple summit participants. | ||
| Centers for Disease Control and Prevention: Prevention Measures to Reduce Maternal and Infant Mortalitya | ||
| Before conception | ||
| Screen women for health risks and pre-existing chronic conditions, such as diabetes and hypertension. | ||
| Advise women to avoid alcohol, tobacco, and illicit drugs. | ||
| During pregnancy | ||
| Provide women with early access to high-quality care throughout pregnancy, labor, and delivery. | ||
| Educate women about the early signs of pregnancy-related problems. | ||
| During postpartum period | ||
| Provide information about well-baby care and benefits of breastfeeding. | ||
| Educate parents about how to protect their infants from exposure to infectious diseases and harmful substances. | ||
| Maternal Mortality Review Committee: Identified Contributing Factors and Strategies to Prevent Future Pregnancy-Related Deatha | ||
| Level | Contributing factor | Strategies to address contributing factor |
| Community | Unstable housing | Prioritize pregnant and postpartum women for temporary housing programs |
| Health facility | Limited experience with obstetric emergencies | Implement obstetric emergency simulation training for emergency department and obstetric staff members |
| Patient/family | Nonadherence to medical regimens or advice | Strengthen and expand access to patient navigators, case managers, and peer support |
| Provider | Missed or delayed diagnosis | Offer provider education on cardiac conditions in pregnant and postpartum women |
| System | Case coordination or management | Implement a postpartum care transition bundle for better integration of services for women at high risk |
a
Some examples of prevention measures and contributing factors and strategies are provided, but these do not represent the complete list.
EPMM, Ending Preventable Maternal Mortality.