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While the rate of pregnancy-related death steadily increases in the United States, this tragic outcome is disproportionately devastating US-born non-Hispanic Black women at a rate that is three to four times that of their White and non-Black Hispanic counterparts. These disparities persist despite controlling for variables such as socioeconomic status, education levels, and geographical location. Pregnancy-related deaths in Black women are largely cardiovascular in etiology, and while these complications also occur in women of other ethnic backgrounds, they often are more severe and more deadly in Black women. This population often lacks adequate prenatal care likely because they face personal and structural barriers. Reversal of barriers during the prenatal period, the implementation of medical protocols during delivery, and the assurance of close follow-up during the postpartum year are vital in improving outcomes. This article will detail seven specific concerns within perinatal care and pregnancy-related death, and offer potential solutions to addressing them. Pregnancy-related death in Black women is not as an isolated event, but rather is one adverse outcome that exists on a broad spectrum of adverse outcomes. Now is the time to reckon with the reality that our nation's Black women are dying at a disproportionate rate compared to women of other ethnicities due to pregnancy-related complications and suffering lifelong consequences even if they escape this fatal outcome. This is a call to action to understand this deeply devastating, multi-factorial issue so we may strive to eliminate this highly preventable and tragic event altogether.

Maternal deaths are rare events in industrial nations due to high quality medical services. These are often unexpected deaths occurring during pregnancy and labor, thus often requiring forensic autopsies. Our analysis will provide an overview of the expected range of causes of death. A retrospective analysis was carried out on all autopsies performed at the Department of Legal Medicine in Hamburg, Germany, over the last 34 years. Autopsies were carried out on 57 cases of maternal death over the 34- year period, i.e. 1 or 2 cases per year. The average age of women was 30 years. Approximately two thirds of deaths occurred during pregnancy. Cardiovascular events accounted for the leading causes of death from natural causes, suicides were the leading causes of non-natural death. Maternal deaths remained consistently rare over the examination period. There was a wide range of causes of death involving natural and non-natural causes.

Maternal suicide, once overlooked in mortality rates, is now recognized as a major contributor to pregnancy-related deaths in the United States. Recent data highlighting a surge in general population suicides underscores the urgency of addressing maternal suicide. It ranks among the top three causes of pregnancy-related deaths, accounting for up to 20% of maternal fatalities. While data collection challenges persist, state Maternal Mortality Review Committees are enhancing consistency in reviewing and documenting maternal deaths. Mental health conditions, particularly suicide, are identified as a key underlying cause, contributing to nearly 23% of pregnancy-related deaths, with 80% considered preventable. Recognizing the lasting societal impact, preventive efforts for maternal suicides should be prioritized. The effects of maternal mental distress and suicidality on child development emphasize the need for interventions across clinical, systemic, and policy domains. [ABSTRACT FROM AUTHOR]

The US is the only developed country in the world with rising maternal mortality. This article discusses factors that contribute to this rise, disparities in maternal mortality, and steps nurses can take to help reverse this worsening trend. [ABSTRACT FROM AUTHOR]

In July 2019, the Centers for Disease Control and Prevention released data for 2018 that indicated a rise in preterm births (birth at <37 weeks' gestation). This increase marks the fourth consecutive year that the United States has seen an increase in infants born too soon or too small. March of Dimes examined these data for its annual report card, giving the nation a "C" letter grade for this dismal outcome. This rise coincides with an ongoing increase in pregnancy-related death, the rate of which has more than doubled over the last 25 years in the United States. Racial and ethnic minorities suffer inequitably. Women of color are up to 50% more likely to give birth prematurely. Black, American Indian, and Alaska Native women are 2 to 3 times more likely to die from pregnancy-related causes than white women. A new approach is needed to address these crises. That approach must consider a range of population-based systems-level solutions. [ABSTRACT FROM AUTHOR]

The United States has experienced a steady rise in pregnancy-related deaths over the last 3 decades. The rate of severe maternal morbidity has also increased. It is estimated that approximately 50% of maternal deaths are preventable. National, multidisciplinary, collaborative efforts are required to effectively address this problem. The complex nature of certain conditions and the concomitant risk of significant maternal morbidity and mortality have yielded a subset of women who require obstetric critical care. Institutions and clinicians face challenges as they identify a framework within which to provide this specialized level of care. Systematic, multidisciplinary review of maternal morbidity and mortality events continues to generate meaningful data and recommendations for improvement. The purpose of this article was to describe important concepts related to maternal mortality including the classification and leading causes of maternal death in the United States. The preventability of maternal mortality is also explored including evidence-based best practices and strategies. [ABSTRACT FROM AUTHOR]