The proportion of women who experienced serious complications while giving birth in U.S. hospitals rose 45 percent between 2006 and 2015, according to a report released today by the Agency for Healthcare Research and Quality (AHRQ).
The analysis, based on data from AHRQ’s Healthcare Cost and Utilization Project (HCUP), explored overall trends in severe maternal morbidity and mortality while identifying areas of particular concern. The new report indicates, for example, that rates of acute renal failure, shock, mechanical ventilation use and sepsis at delivery all more than doubled during the 10-year period.
“This report provides an essential update to our understanding of an urgent public health issue,” said AHRQ Director Gopal Khanna, M.B.A. “With these data in hand, State and Federal agencies, patient safety experts and health systems can evaluate maternal morbidity trends in greater depth, a vital step before addressing the challenge.”
AHRQ’s new statistical brief, “Trends and Disparities in Delivery Hospitalizations Involving Severe Maternal Morbidity, 2006-2015,” provides detailed statistics on complications involving labor and delivery:
- The rate of severe complications increased 45 percent overall during a 10-year period, from 101 per 10,000 delivery hospitalizations in 2006 to 147 per 10,000 in 2015.
- Some severe conditions involved medical procedures. In 2015, for example, blood transfusions occurred with more than half of deliveries among mothers who were in shock, had an amniotic fluid embolism, were experiencing a sickle cell disease crisis or had disseminated intravascular coagulation (the formation of blood clots throughout the body). One-third of deliveries with shock had a hysterectomy.
- In 2015, rates of severe maternal morbidity were highest among poor mothers, for those over the age of 40, or uninsured or on Medicaid or lived in large urban areas.
The report also underscored racial and ethnic disparities among women who experienced severe complications. For example, although deaths decreased overall, black women were three times more likely than white women to die as a result of delivering a baby in 2015 (11 versus 4 deaths per 100,000 delivery hospitalizations, respectively). Compared with white women, severe maternal morbidity was 110 percent more likely among black women, 40 percent more likely among Hispanic women and 20 percent more likely among Asian/Pacific Islander women in 2015.
To help hospitals reduce the occurrence of severe maternal morbidity, AHRQ developed the Safety Program for Perinatal Care to improve communication and the quality of care of labor and delivery units to reduce maternal morbidity and neonatal adverse events. The toolkit builds on knowledge gained from AHRQ's Comprehensive Unit-based Safety Program (CUSP), TeamSTEPPS® team training system and patient safety and medical liability initiative demonstration grants.
In addition, AHRQ is working with colleagues at the HHS Health Resources and Services Administration to integrate key components of teamwork and safety culture training strategies into The Alliance for Innovation on Maternal Health program’s maternal safety bundles.
AHRQ is the lead Federal agency charged with improving the safety and quality of America’s health care system. AHRQ develops the knowledge, tools and data needed to improve the health care system and help Americans, health care professionals and policymakers make informed health decisions. Learn more about the Agency at www.ahrq.gov.