The decreasing mortality rates within the in-patient delivery setting demonstrated as statistically significant and a welcome finding for all women. This study looked at in-patient delivery-related outcomes and found a 57% decrease from 2008-2021. This includes looking into root causes of mortality and the impact of pre-existing conditions on delivery-related complications to identify opportunities and effect optimal maternal health outcomes. Response: HHS is committed to advancing maternal and infant health research. : What recommendations do you have for future research because of this study? This includes HHS quality improvement activities such as state Perinatal Quality Collaboratives and the Alliance for Innovation on Maternal Health, and ties into the Administration’s commitment to addressing the maternal health crisis through initiatives in the White House Blueprint for Addressing the Maternal Health Crisis. This decline in deaths during delivery hospitalization likely demonstrates the impact of national and local strategies to improve the quality of care by hospitals during delivery-related hospitalizations.

This study specifically looked at in-patient delivery-related outcomes and found a 57% decrease from 2008-2021. As a result, this has led many people to believe that hospitals may be the main cause of maternal mortality. Much of the reporting on maternal mortality has focused on the increasing maternal mortality rates. Response: Although other studies have documented a decreasing in-patient mortality trend, it may be new information for many. : What should readers take away from your report? The fact that many of the comorbid conditions are risk factors for mortality and SMM indicates that it is essential to consider these conditions when assessing SMM and mortality and that better management of patients’ conditions during pregnancy may help reduce SMM occurrence and ultimately decrease mortality risk. The most common risk factors for these complications are obesity, gestational diabetes, tobacco use, gestational hypertension, and asthma. The most common delivery-related complications identified were disseminated intravascular coagulation, acute respiratory distress syndrome, acute kidney failure, sepsis, and eclampsia. Continued national effort to reduce low risk cesarean deliveries is needed. The study also indicates a correlation to the rise of SMM and association with cesarean births. women giving birth, including increases in maternal age, obesity, and preexisting medical conditions. Severe maternal mortality is likely increasing due to the overall health of U.S. Between 2008 – 2021 SMM for American Indian women increased 57%, Asian women increased 79%, Black women increased 10%, Hispanic women increased 28%, Pacific Islander increased 126%, and White women increased 20% in the study period. This study also drilled further into the data to reflect the impact of severe maternal mortality on race, ethnicity, age, and payer. While these findings do not have the same level of statistical confidence as identified with mortality, this data does clearly support the importance of the need to address maternal health across the continuum.

Response: The severe maternal mortality at the time of delivery increased by 2% annually with an overall increase of 22% from 2008 – 2021. Mortality for American Indian women decreased 92%, Asian women decreased 73%, Black women decreased 76%, Hispanic women decreased 60%, Pacific Islander women decreased 79%, and White women decreased 40% during the study period. This study also looked with greater granularity at the impact of race, ethnicity, and age. The decreasing mortality rates within the inpatient delivery setting demonstrated as statistically significant and a welcome finding for all women. This study specifically looked at inpatient delivery-related outcomes and found a 57% decrease from 2008-2021. hospitals has decreased for all racial and ethnic groups, age groups, and modes of delivery while the prevalence of severe maternal mortality (SMM) increased for all patients, with higher rates for racial and ethnic minority patients of any age. Response: Delivery-related mortality in U.S.

Deputy Assistant Secretary for Women’s Health

Dorothy a fink md