Maternal Morbidity and Mortality Measurement Recommendations Final Report 

Maternal morbidity and mortality are primary indicators of women’s health and the quality of healthcare globally. As of 2018, the U.S. maternal mortality ratio is 17.4 maternal deaths (per 100,000 live births), which is much higher than that of other high-income countries, with more than 700 women dying annually from pregnancy-related causes. Measurement- focused efforts have been gradual in the U.S., starting with the revision of a number of maternal mortality measurement tools. Although not all causes of the rising rates of maternal morbidity and mortality are clear, it is evident that racial disparities are pervasive. This signals a need for recommendations that address disparities and expand maternal morbidity and mortality measurement to improve maternal health outcomes . In 2019-2021, NQF convened a multistakeholder Maternal Morbidity and Mortality Committee to provide recommendations on specific short- and long-term innovative, actionable approaches to improve maternal morbidity and mortality measurement and to propose a recommendation for a maternal mortality measurement concept. The Committee considered a multifaceted range of influencing factors in its recommendations, including clinical care, health equity, state and federal policies, and social determinants of health. The Committee produced two measurement frameworks, one for morbidity and one for mortality, to identify gaps in maternal morbidity and mortality measurement and guide the development of key measurement recommendations. These recommendations will help to build the foundation for improving maternal health outcomes within the U.S. healthcare delivery system.