In 1996, the Florida Department of Health established the Florida Maternal Mortality Review Committee, formerly known as the Pregnancy-Associated Mortality Review, to improve surveillance and analysis of pregnancy-related deaths in Florida.
This program seeks to close gaps in care, identify systemic service delivery issues, and make recommendations to facilitate improvements in the overall systems of care.
Process
The process begins by identifying all pregnancy-associated deaths within a specified period. A pregnancy-associated death is defined as “a death to a woman from any cause, while she is pregnant or within one year of termination of the pregnancy, regardless of duration and site of the pregnancy.” A pregnancy-associated death is identified utilizing linked data files from four sources associated with the mother:
- Death certificates identified by the assigned cause of death being in the category of pregnancy, childbirth, and the puerperium (pregnancy related)
- Florida’s Prenatal Screen (formerly known as the Healthy Start screen)
- Birth certificate/fetal death certificate
- Death certificates with a checked box identifying the woman as either pregnant at time of death, pregnant within 42 days of death, or pregnant between 43 days to one year before death
Once the pregnancy-associated deaths are identified, they are sorted by a physician/nurse subcommittee and initially deemed pregnancy-related, possibly pregnancy-related or not pregnancy-related. The focus Florida’s Maternal Mortality Review Committee is to assure that all deaths identified as pregnancy-related deaths are reviewed.
Definitions
A pregnancy-related death is defined as “a pregnancy-associated death resulting from one of the following:
- Complications of the pregnancy itself
- Chain of events initiated by the pregnancy that led to death
- Aggravation of an unrelated condition by the physiologic or pharmacologic effects of the pregnancy that subsequently caused the death
The Maternal Mortality Rates, reported by the Office of Vital Statistics, are based on deaths identified by the assigned cause of death being in a pregnancy related category and in recent years by the addition of a pregnancy check box on the death certificate. Vital Statistics defines maternal mortality as “the death to a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by pregnancy or its management but not from accidental or incidental causes.”
Through the utilization of a broader definition, as well as the increased sources of linked data, Florida’s Maternal Mortality Review Committee is able to assess more accurately the pregnancy-related deaths in Florida.