Pregnancy Mortality Surveillance System

by Sara Alvarado

Updated June 3, 2024
When a woman gets pregnant, it’s usually a thing of joy. But the new life growing within her brings uncertainties too. And there’s a good reason for this: many women die in the United States due to pregnancy-related complications.

There’s good news though. Modern medicine has taken us lightyears forward in terms of managing the risks connected to pregnancy. But, women continue to die in childbirth and up to the first year postpartum due to complications. It is very tragic and can only beg for further research.
Pregnancy Mortality Surveillance System

Image Credit: CNN Newsroom on KTVZ

In response, it’s obvious we may need data-driven insights to get a clear idea of what causes these deaths. Having enough statistical data gives the government and healthcare providers a chance at providing solutions to maternal deaths. That is exactly what PMSS is all about.

Let’s start with a definition.

1. What is the Pregnancy Mortality Surveillance System (PMSS)?

The PMSS is a public health surveillance system. It is dedicated to tracking pregnancy-related deaths across the United States. The vision of PMSS goes beyond counting the statistics and hence seeks to unravel what led to these disastrous incidents spanned over a particular time.

When a woman dies during pregnancy or in labor, it quite obviously can be classified as a pregnancy-related death. However, according to the PMSS definition, a pregnancy-related death is more than that.

It is also any maternal death that happens within one year of pregnancy. That is, even if the death stemmed from complications either directly caused by or exacerbated during the pregnancy or its management.

This wider definition broadens the understanding of what is considered “pregnancy-related risk,” and includes even underlying pregnancy-related risks (what providers describe broadly) which might not be visible at the onset.

2. The PMSS VS. Traditional Death Certificates

Rather than just using death certificates, which typically only list the deaths in the 42 days following childbirth, PMSS gives a fuller picture. This longer time period allows deaths caused by complications leading to things like infections or mental health conditions from the pregnancy to be counted.

So what the PMSS does is draw information from dozens of different places to form a much broader and granular picture. Trained medical professionals review all this data with air-tight accuracy and precision to identify not only the root cause of death but also understand the correlation attached.

Crucial too is this comprehensive approach. Let's say, for instance, a woman dies from a blood clot months after giving birth to her second child. A standard death certificate might exclude details that link the death to pregnancy.

The PMMS system, on the other hand, takes all these tiny details into consideration. With information as granular as the PMSS provides, public health experts can now understand the causes of pregnancy-related deaths And not only that, because with this wealth of information, they are better informed to avert similar deaths due to postpartum complications in the future.

3. So, Why is the PMSS So Important?

CLearning what is behind pregnancy-related deaths is essential to designing effective interventions for reducing the maternal mortality rate. PMSS data can provide a snapshot of the major causes of death, including hemorrhage (excessive bleeding), pre-eclampsia (high blood pressure during pregnancy), and infections. Recognizing these trends enables health professionals and caregivers to focus their energies on preventing the aforementioned complications.

For example, if PMSS data indicate an increased mortality due to pregnancy-related postpartum hemorrhage, then interventions related blood transfusion accessibility and improved teaching in how to manage bleeding at delivery can be recipients of aid.

Equally identifying an increased risk of pre-eclampsia in one ethnic group over and above others could drive the implementation of ethnicity-targeted prenatal screening programs for early detection and intervention.

4. PMSS: Statistics Paint a Clearer Picture

Pregnancy Mortality Surveillance System

Image Credit: The CDC

The PMSS not only monitors pregnancy-associated deaths. It turns the data into useful intel. Now, health experts can act intelligently to curb maternal deaths in the U.S.

To better understand the usefulness of precise data collection in healthcare, let’s look at a statistic: Every year, for every 100,000 women, about 14 women tragically lose their lives during pregnancy or due to complications after delivery.

While as a proportion of the total population, this number may appear to be less, it still constitutes an important public health issue. In addition, the PRMR is heterogeneous among racial and ethnic groups.

These patterns are also evident, albeit with even higher PRMRs among African American, American Indian, and Alaska Native women (3 to 4 times greater than that of White women). These findings underscore the importance of providing targeted interventions to overcome disparities and improve the universal quality of women's facility-based maternal health care.

PMSS even provides state-level data beyond national statistics. This Featured Map helps state and local health partners to find states with higher PRMRs. Think of a state that is particularly deadly from pre-eclampsia. Through analyzing PMSS data, officials might find that specialized prenatal care services capable of handling high-risk pregnancies are simply not available.

5. Limitations of the PMSS

However, it is also important to recognize that as useful as the PMSS may be, there are some limitations. An additional concern is that pregnancy-related deaths are possibly systematically underreported.

A limitation is the sophisticated manner of data analysis. Pregnancy-related deaths can also result from many factors combined, making it exceptionally difficult to attribute any death to a single identifiable cause. This is mitigated through a thorough investigation of medical records and other available data to discern these contributing factors by trained epidemiologists working within the PMSS.

Despite this limitation, the PMSS remains an invaluable resource for improving maternal health. By continuously refining data collection methods and analysis techniques, public health officials can strive for a more comprehensive understanding of pregnancy-related deaths.

6. Conclusion

PMMS data allows us to pinpoint patterns, grasp risk contributors, and ultimately work together on solutions that can stop the next tragedy.

However, the fight for improved maternal health outcomes requires a collective effort. While the PMSS plays a critical role in informing best practices, individual awareness and action are also essential.

Stay updated. Read more insightful articles on our websites and make the best choices regarding health and wellness.

7. References

  1. Gazeley, U., Reniers, G., Eilerts-Spinelli, H., Prieto, J. R., Jasseh, M., Khagayi, S., & Filippi, V. (2022). Women’s risk of death beyond 42 days post partum: a pooled analysis of longitudinal Health and Demographic Surveillance System data in sub-Saharan Africa. the Lancet. Global Health/the Lancet. Global Health, 10(11), e1582–e1589.
  2. Maternal mortality rates in the United States, 2020. (n.d.).
  3. Pregnancy complications. (2023, July 19). Johns Hopkins Medicine.
  4. What are some common complications of pregnancy?(2021, April 20).
  1. Wikipedia contributors. (2024, April 29). Maternal death. Wikipedia.
Article by
Sara Alvarado
Greetings, I'm Sara, a dedicated nurse and a proud contributor to the AutoInfu blog. With my firsthand experience in the world of infusion pumps, I'm here to provide you with the latest insights, expert advice, and essential updates to ensure you stay informed about the infusion pump industry.

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