Maternal Morbidity and Mortality

On October 18, 2018, IDPH released Illinois’ first Maternal Morbidity and Mortality Report. The report identifies statewide trends in maternal deaths and provides recommendations to help prevent maternal mortality. The report is the culmination of more than a year of work done by two IDPH committees, the Maternal Mortality Review Committee (MMRC), established in 2000, and the Maternal Mortality Review Committee for Violent Deaths (MMRC-V), established in 2015.  Committee members aimed to gain a better understanding of the causes of maternal mortality, to develop statewide recommendations to prevent future maternal mortalities, and to determine whether the deaths were pregnancy-associated (occurring within one year due to any cause) or pregnancy-related (occurring within one year due to pregnancy).

IDPH remains committed to identifying and reviewing maternal deaths and morbidities and will build upon these findings and recommendations over the coming years. The subcommittees have started reviewing 2016 maternal deaths in an effort to identify changing trends and areas for statewide improvement with the ultimate goal of preventing maternal mortality.

On April 29, 2021, IDPH released Illinois' second Maternal Morbidity and Mortality Report.

2021 Maternal Morbidity and Mortality Report Virtual Press Conference

Maternal Health as a Continuum

Health outcomes during pregnancy and the postpartum period occur across a continuum. Most women are healthy during pregnancy, meaning they experience a typical outcome with no complications. However, some women experience pregnancy complications, which may be minor or severe, and may cause significant short- and/or long-term consequences to a woman’s health. Severe complications are rare, with a relatively small number of women experiencing the most severe complication: death.

What is Maternal Morbidity?

Maternal morbidity refers to any pregnancy or delivery complication, which may be minor or severe. Maternal morbidities may cause significant short- and/or long-term consequences to a woman’s health.

What is Maternal Mortality?

Maternal mortality is the death of a woman during pregnancy, childbirth, or the postpartum period, and it serves as a sensitive indicator of the quality of the health and health care of a community. Many different definitions of maternal mortality are used to track and analyze deaths in different contexts, but Illinois uses the following standard definitions from the Centers for Disease Control and Prevention (CDC):

Pregnancy-Associated Death - the death of a woman during pregnancy or within one year of the end of a pregnancy from any cause.

Pregnancy-Related Death - The death of a woman during pregnancy or within one year of the end of a pregnancy from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy.

Maternal Mortality Review Committees

The Illinois Department of Public Health supports two Maternal Mortality Review Committees, which:

  • Identify cause of death
  • Determine if the death was pregnancy-related
  • Determine if the death was preventable
  • Develop recommendations to prevent deaths

Maternal Mortality Review Committee (MMRC)

Reviews deaths suspected to be medically related to pregnancy.

Maternal Mortality Review Committee on Violent Deaths (MMRC-V)

Reviews deaths resulting from homicide, suicide, or drug overdose.

An average of 75 women die each year while pregnant or within one year of pregnancy.

 

That is 1 death every 5 days

About 1 in 3 pregnancy-associated deaths were pregnancy-related.

 

Timing among pregnancy-related deaths

1 in 3 women died while pregnant

1 in 3 women died during the first 2 months postpartum

1 in 3 women died 2 or more months postpartum

More than 4 out of 5 pregnancy-related deaths were preventable.

 

Mental health conditions, including substance use disorder, were the leading cause of pregnancy-related deaths.

Black women are most likely to die from pregnancy-related causes.

Black women are about three times as likely to die from a pregnancy-related condition as White women.

Black women were more likely to die from pregnancy-related medical conditions.

White women were more likely to die from pregnancy-related mental health conditions.

Examples of Key Maternal Mortality Reviews Committee Recommendations

  • Health insurance plans should reimburse for telehealth.
  • The state should expand home visiting programs.
  • Hospitals should provide training and resources to staff on racism, implicit bias, and stigma.
  • Hospitals should establish policies to ensure appropriate treatment of women with substance use disorders and support opioid overdose prevention.
  • Providers should ensure all women are discharged from the hospital with an early postpartum visit within three weeks of pregnancy.
  • Providers should ensure women are connected to mental health services.
  • Community-based organizations should educate women on the importance of getting prenatal care.
  • All women should have an annual well-woman visit.

Ongoing Efforts to Improve Maternal Health

Current initiatives to improve maternal health in Illinois

  • Illinois was the first state to extend continuous eligibility for full Medicaid benefits from 60 days to 12 months postpartum.
  • The Illinois Perinatal Quality Collaborative is planning a Birth Equity Initiative for birthing hospitals to address bias, racism, and social factors influencing maternal health.
  • IDPH is funding local organizations to increase the number of women receiving well-woman exams.
  • IDPH is expanding funding and increasing awareness of the state perinatal depression MOMS hotline.
  • The Illinois Department of Human Services is piloting the Illinois Families in Recovery program for pregnant and postpartum women with substance use disorders in central Illinois.
  • IDPH will continue to support the Maternal Mortality Review Committees and will use new data tools to look at social and community factors influencing maternal health.

More Information and Resources

Resource lists for women and their families are available in Appendix A of the report.

Resource lists for health care providers are available in Appendix B of the report.

Data Sources and Methodology

Using a variety of data sources, the Illinois Department of Public Health identifies all deaths of women while pregnant or within one year of pregnancy (pregnancy-associated deaths). The two Maternal Mortality Review Committees reviewed 129 maternal deaths that occurred during 2016-2017 to develop the recommendations in the report.

For more information, contact: DPH.MCH@illinois.gov