The United States' rising maternal mortality ratio continues to generate alarm and confusion.
[i] This national trend in maternal mortality is not an emerging issue: since 1986, the Centers for Disease Control and Prevention (CDC) has administered the Pregnancy Mortality Surveillance System, which has documented a rise in the national pregnancy-related mortality ratio for the past three decades.[ii] For fifteen years, AMCHP has collaborated with national partners, including the CDC, to build the capacity of state-based teams, with a special focus on Title V programs, to conduct maternal mortality and morbidity surveillance, including maternal mortality review, and translate those findings into population-based action.
Below are some of the efforts AMCHP leads or supports to help its members review and prevent maternal deaths and improve the quality and safety of maternity care and the health of our nation's mothers.
Review to Action (www.ReviewToAction.org)
Review to Action is a resource developed by AMCHP in partnership with the CDC Foundation and the CDC Division of Reproductive Health. Review to Action is a product of a larger initiative entitled, Building U.S. Capacity to Review and Prevent Maternal Deaths led by the CDC Foundation that also includes the Maternal Mortality Review Information Application, or MMRIA. This joint effort launched in January 2016. The project is supported by funding from Merck, through an award agreement with its Merck for Mothers program. The goal of Review to Action is to promote the state-based maternal mortality review process as the gold standard for maternal mortality surveillance and intervening in pregnancy-related death. Only approximately half the states in the U.S. have a maternal mortality review committee in place. Those that do are continually looking to enhance the quality and comprehensiveness of their process and their capacity to implement findings from the committee. To learn more, access best practice resources, and individual state review committee profiles, go to
www.reviewtoaction.org or email
AMCHP Every Mother Initiative
With support from
Merck for Mothers, the AMCHP Every Mother Initiative launched in 2013 to help states take specific and focused steps to reduce maternal mortality and severe morbidity. Between 2013 and 2016, AMCHP facilitated two Action Learning Collaboratives, each with six states, to strengthen state maternal mortality review capacity and translate findings from these reviews into population-based action to prevent maternal deaths.
States Participating in the Every Mother Initiative ALC
Cohort 1 (August 2013 - Oct 2014): Colorado, Delaware, Georgia, New York, North Carolina, & Ohio.
Cohort 2 (October 2014 - December 2015): Florida, Illinois, Louisiana, Missouri, Oklahoma, & Utah.
Alliance for Innovation on Maternal Health
Alliance for Innovation on Maternal Health (AIM-Maternal Health)
partners with states and major hospital systems to implement maternity safety bundles across birth facilities in at least eight states over the four years of the project. AIM is funded through a cooperative agreement with the American College of Obstetricians and Gynecologists (ACOG) from the Maternal and Child Health Bureau/Health Resource Services Administration, and its goal is to prevent 1,000 maternal deaths and 100,000 cases of severe maternal morbidity nationally by 2018. AMCHP is a core partner on AIM-Maternal Health to follow through on our efforts to build capacity in states to translate findings from maternal mortality surveillance activities into population-based action. Title V also has a unique role to play in these quality improvement initiatives, having a longstanding history of building cross-sector teams for collective impact and ensuring health equity and continuity of care and support. AMCHP served on the workgroup to develop the bundle,
Reducing Peripartum Racial/Ethnic Disparities.
Resources and Tools
Maternal Health Resource and Planning Guide for States
Released in May 2015, Health for Every Mother offers a menu of strategies supported by examples from more than 30 states and a wealth of national program and policy resources. The guide also includes assessment tools for use internally or with partners. Contact us about opportunities to use the guide or to request a hard copy by mail.
Click here to download the full guide, optimized for web viewing. Interested in promoting the guide in your state or hoping to share it with your partners? Sample social media posts and e-newsletter content can be found
NAMD/AMCHP Issue Brief on Low-risk, Primary Cesarean Births in Medicaid
This Issue Brief, developed by the National Association of Medicaid Directors (NAMD) in partnership with AMCHP, lays out key background information and the elements of state strategies to address the excessive use of C-sections for low-risk, first time mothers. It is important to note that this resource seeks to provide a high-level review of state options and does not offer a comprehensive analysis of this topic. To view this issue brief, click
AMCHP hosted a national Postpartum Think-Tank meeting in December 2014 with the goal of illuminating the needs and solutions surrounding postpartum health and its link to better birth outcomes. This meeting was held in partnership with the National MCH Workforce Development Center, housed in the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill. The meeting findings are presented in an infographic which frames the challenges and proposed solutions from the woman's perspective. Read about the findings of the meeting and the infographic here.
For more information about AMCHP's maternal health efforts, please contact:
Andria Cornell, MSPH
Senior Program Manager, Women's Health
[i] MacDorman, M. F., Declercq, E., Cabral, H., & Morton, C. (2016). Recent Increases in the U.S. Maternal Mortality Rate: Disentangling Trends From Measurement Issues. US National Library of Medicine National Institute of Health . Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001799/
[ii] Pregnancy Mortality Surveillance System. (2017, January 31). Retrieved May 10, 2017, from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html