WHO Links Maternal Deaths to System Instability
A recent WHO-hosted webinar examined the connection between maternal mortality and the stability of health systems. The discussion concluded that systemic factors such as staffing levels, infrastructure, and policy are as crucial as individual clinical care in preventing deaths.
- Globally, nearly two-thirds of all maternal deaths occur in countries experiencing conflict or fragility. The maternal mortality ratio in conflict-affected countries is estimated to be 504 deaths per 100,000 live births, compared to 99 in stable countries. - Severe bleeding is the leading cause of maternal death worldwide, accounting for over a quarter of all deaths. Other major causes include high blood pressure during pregnancy (pre-eclampsia and eclampsia), infections, and complications from unsafe abortions. - A global study indicated that the nursing and midwifery workforce size accounts for nearly half of the variation in maternal mortality ratios worldwide. Expanding this workforce is considered a critical factor in reducing maternal deaths, especially in low- and middle-income countries. - In Virginia, the pregnancy-associated death rate was 70.1 per 100,000 live births in 2022, an increase from 66.9 in 2021. For Black women in the state, the maternal mortality rate between 2018 and 2021 was 55.0 per 100,000 births, more than double the rate for white women. - The integration of a robust midwife workforce could avert an estimated 41% of maternal deaths globally. Midwives are trained to provide a significant portion of essential maternal and newborn care, leading to fewer interventions, lower costs, and improved patient satisfaction. - There is a projected national shortage of approximately 5,170 obstetricians by 2030, increasing the demand for nurse-midwives. Organizations like the American College of Nurse-Midwives (ACNM) advocate for policy changes, such as the "Midwives for MOMS Act," to increase the supply and diversity of midwives. - Digital health technologies, such as telehealth and remote patient monitoring, are emerging as tools to bridge gaps in maternal care, particularly in underserved and rural areas. These technologies can help manage high-risk pregnancies by providing regular monitoring and connecting patients with specialists. - In a 2023 report, the Virginia Maternal Mortality Review Team found that over half of pregnancy-associated deaths had at least one provider-related contributing factor, with "failure to screen for risk" being the most prevalent.
