The Opportunity
The National Quality Forum (NQF) recognizes the role of quality measurement in reducing maternal morbidity and mortality in the United States. Maternal mortality is defined as a death that occurs up to one year after the pregnancy ends, which may be caused by a pregnancy complication, a chain of medical events started by the pregnancy, the worsening of an unrelated condition because of the pregnancy, or other factors. Maternal morbidity refers to unexpected short- or long-term negative outcomes that result from pregnancy or childbirth.1 Quality measurement can improve maternal health outcomes by providing needed information on innovations in measurement methodologies and limitations in care.
Ensuring every person in every community receives high quality, safe care relies on transparency of valid healthcare quality information. Today, the United States is the only industrialized nation with a rising maternal mortality rate, with more than 700 women dying annually from pregnancy related causes (17.2 deaths per 100,000 live births).2 Severe maternal morbidity affects more than 60,000 women annually in the US, with rising trends over the last two decades.3,4,5 Although these rates vary by region, state, and across racial and ethnic lines, significant disparities persist with rates highest among non-Hispanic black women (42.8 per 100,000 live births) and American Indian/Alaska Native (32.5 per 100,000 live births) women, as compared to Asian/Pacific Islander non-Hispanic women (14.2 per 100,000 live births), white non-Hispanic women (13.0 per 100,00 live births), or Hispanic women (11.4 per 100,000 live births).6
Objectives
NQF will engage with this issue by building a foundation for larger measurement goals focused on maternal morbidity and mortality. This project will involve:
- The convening of a multistakeholder committee of experts to advise and guide NQF’s work;
- The development of an Environmental Scan Report on the quality measurement landscape for maternal morbidity and mortality;
- The development of a Recommendations Report which will describe measurement frameworks for maternal morbidity and mortality.
Over a 24-month period of performance, NQF will complete the Environmental Scan and a Recommendations Report. Throughout this project, NQF will solicit input from NQF’s multi-stakeholder audience at key points, including NQF membership and public stakeholders.
Funding
This project is funded by the Department of Health and Human Services. For more information about the availability of auxiliary aids and services for NQF’s federally funded projects, please visit http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html.
Related NQF Work
Contact Information
For more information, please contact the project team via email at maternal@qualityforum.org.
1 CDC. (2018). Pregnancy-related deaths. Retrieved June 29, 2019, from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-relatedmortality.htm
2 Centers for Disease Control and Prevention. Severe maternal morbidity in the United States. 2017. Available at: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/severematernalmorbidity.html
3 Howell E.A. (2019) Reducing Disparities in Severe Maternal Morbidity and Mortality. Clinical Obstetrics and Gynecology. 61(2), 387-399.
4 Callaghan W.M. Creanga A.A. and Kuklina E.V. (2012). Severe maternal among delivery and postpartum hospitalization in the United States. Obstetrics and Gynecology 120, 1029-1036.
5 Centers for Disease Control and Prevention. Severe maternal morbidity in the United States. 2017. Available at: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/severematernalmorbidity.html
6 Centers for Disease Control and Prevention. Severe maternal morbidity in the United States. 2017. Available at: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/severematernalmorbidity.html