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Maternal Mortality and Morbidity in the United States: Classification, Causes, Preventability, and Critical Care Obstetric Implications

Troiano, Nan H., MSN, RNC-OB, NE-BC, C-EFM; Witcher, Patricia M., MSN, RNC-OB

The Journal of Perinatal & Neonatal Nursing: July/September 2018 - Volume 32 - Issue 3 - p 222–231
doi: 10.1097/JPN.0000000000000349
Feature Articles

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.

Consultant, Perinatal Nursing, Arley, Alabama (Ms Troiano); and Northside Hospital, Atlanta, Georgia (Ms Witcher).

Corresponding Author: Nan H. Troiano, MSN, RNC-OB, NE-BC, C-EFM, PO Box 465, Arley, AL 35541 (

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Each author has indicated that he or she has met the journal's requirements for Authorship.

Submitted for publication: March 25, 2018; accepted for publication: May 8, 2018.

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