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0070 Data to action: maternal mortality reviews addressing injury prevention
  1. Andria Cornell
  1. AMCHP, Washington, DC, USA

Abstract

Statement of purpose From 2006–2009, 900 pregnancy-related deaths occurred per year in the U.S. (more than 2 deaths/day) (CDC Pregnancy Mortality Surveillance System, 2013). In the same period, the pregnancy-related mortality rate among black women was three times that of white women (35.6 compared to 11.7 deaths per 100,000 live births). For many states, injury and violence are leading causes of death during pregnancy and up to one year post delivery. These deaths are preventable, but unlike obstetric emergencies, population-based strategies to prevent injury-related maternal death can be especially complex. Action learning collaboratives can serve as venues for peer learning and experimentation.

Methods/Approach AMCHP launched the Every Mother Initiative in 2013 to help states implement strategies to strengthen their maternal mortality surveillance and use data from mortality reviews to implement population-based strategies to prevent maternal death. The initiative includes two 15-month Action Learning Collaboratives (ALC) comprising of two cohorts of six states. ALCs are multidisciplinary learning communities that analyse a public health problem and implement program and policy solutions. Participation in the ALC includes technical assistance, site visits, and a sub-award to implement a data-to-action project. The six states in the first cohort included CO, DE, GA, NC, NY, and OH.

Results Every Mother Initiative states eagerly sought out opportunities to prevent injury-related deaths. Between 2004 and 2012, leading causes of maternal mortality in Colorado included accidental drug overdose, motor vehicle crash, suicide, cardiovascular conditions, and homicide (CO Maternal Mortality Prevention Program, 2014). Colorado’s Every Mother project included qualitative interviews and focus groups with women who had experienced severe depression, substance abuse, or intimate partner violence to learn critical systems factors that enabled them to receive support. Delaware and Ohio increased injury-related representation of expertise on their maternal mortality reviews and completed analyses of racial disparities by manner of death.

Conclusions State-based maternal mortality reviews are important partners in implementing population-based injury and violence prevention strategies, marshalling critical resources around a specific sentinel indicator.

Significance and contribution to the field Maternal mortality reviews can play an important role in weaving together a culture of safety among clinicians, public health, law enforcement, advocacy organisations, and community members.

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