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of the Commonwealth of Pennsylvania

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    ​​​​Maternal Mortality and Morbidity

    Maternal mortality is devastating for families and communities worldwide. In Pennsylvania specifically, a large disparity in mortality exists between white and African American individuals. Unfortunately, mortality is just the tip of the iceberg: for every individual who dies, there are more who just barely survive. 

    What is Maternal Mortality?

    Maternal mortality is a death of an individual during pregnancy, or up to one year following the end of the pregnancy, regardless of the outcome of the pregnancy. Maternal mortality applies in cases of livebirth, stillbirth, abortion and miscarriage. When describing maternal mortality, deaths are divided into the following categories:

    Pregnancy-Associated Deaths: the death of a woman during pregnancy, or up to one year following the end of the pregnancy, regardless of the outcome of the pregnancy.

    • Pregnancy-associated deaths: the death of an individual during pregnancy, or up to one year following the end of the pregnancy, regardless of the outcome of the pregnancy.
    • Pregnancy-related death: the death of an individual during pregnancy or within one year of the end of a pregnancy - regardless of the outcome, duration or site of the pregnancy - due to a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy.
    • Pregnancy-associated, but not related death: the death of an individual during pregnancy or within one year of pregnancy from a cause that is not related to pregnancy. These are deaths from accidental or incidental causes, such as a death due to a natural disaster.

    To better understand maternal mortality and how to prevent these deaths, Pennsylvania established the Pennsylvania Maternal Mortality Review Committee (PA MMRC) to review all pregnancy-associated deaths in the commonwealth. 

    What is a Maternal Mortality Review Committee (MMRC)?

    A MMRC is a multidisciplinary group of professionals and partners who serve pregnant and postpartum individuals, and who collectively review deaths and examine factors that led to the death. The goal of a MMRC is to determine if the death is related to the pregnancy and if it could have been prevented. The committee then provides recommendations that could prevent future deaths and protect the health and well-being of individuals during and after pregnancy.

    Pennsylvania Maternal Mortality Review Committee

    In 2018, the PA MMRC was established by Act 24 to confidentially conduct a multidisciplinary review of maternal mortality in Pennsylvania. Under the act, the Department of Health has authority to appoint members to the committee and maintain a minimum committee representation. It also allows the committee to consult with relevant experts or stakeholders.

    The PA MMRC reviews de-identified summaries of all pregnancy-associated deaths in the commonwealth, regardless of cause of death and including drug-related deaths, homicides, and suicides. The committee determines if the death was related to the pregnancy, identifies contributing factors, determines if the death could have been prevented, and makes recommendations to prevent future deaths. A death is considered preventable if the committee determines that there was at least some chance of the death being avoided by one or more reasonable changes to patient, family, provider, facility, system and/or community factors.

    The PA MMRC works closely with the Philadelphia MMRC, which reviews deaths of Philadelphia mothers. The Philadelphia MMRC is housed within the Philadelphia Department of Public Health, Division of Maternal, Child and Family Health. The Philadelphia MMRC began in 2010 and is made up of representatives from every labor and delivery hospital in Philadelphia, as well as diverse disciplines.

    Severe Maternal Morbidity

    Severe Maternal Morbidity (SMM) includes unexpected outcomes of labor and delivery that can result in significant short- or long-term health consequences. In 2023, Act 5 amended the Maternal Mortality Review Act to require an annual report on Severe Maternal Morbidity data in Pennsylvania. Among the patient characteristics, the highest rate of SMM from 2016-2022 was observed among individuals aged 35 years and older, non-Hispanic Black individuals, individuals residing in urban geographic areas, those with Medicaid/Medicare as their primary payer, and those who delivered by cesarean section.

    The Maternal Health Crisis in the US and Pennsylvania

    • About 800 people die from pregnancy-related complications each year in the U.S.2
    • In 2022, the pregnancy-related mortality ratio for the U.S. was 22.3 per 100,000 live births.2
    • Compared to individuals who are white, individuals who are American Indian/Alaska Native and Black are 2 to 3 times more likely to die from a pregnancy-related cause.2
    • The maternal mortality rate for Pennsylvania from 2016-2020 was 10.6 per 100,000 live births.4
    • According to the Maternity Care Deserts Report published by the March of Dimes, 7.5% of counties in Pennsylvania are maternity care deserts. This number is expected to rise due to hospital closures. A maternity care desert is any county in the United States without a hospital or birth center offering obstetric care and without any obstetric providers. 5
    • In Pennsylvania, 12.4% of individuals had no birthing hospital within 30 minutes of their home. 5

    View more information and resources to support healthy pregnancies.

    Sources

    1. Severe Maternal Morbidity in Pennsylvania, 2016-2022: Individual level & Regional Factors
    2. Maternal Mortality Rates in the United States, 2022 (cdc.gov)
    3. Racial Disparities in Maternal Health
    4. MICH-04: Maternal mortality rate (LHI)
    5. Maternity Care in Pennsylvania (marchofdimes.org)​