MATERNAL CARE QUIZ

How Does Your OB Care Measure Up?

Key obstetric outcome measures provide insights into maternal care quality and ultimately help prevent maternal mortality and morbidity. Compare your health system or practice by answering the following questions.

Question 1: Maternal Mortality

Maternal deaths are a critical indicator of the overall safety of maternal care. What do you estimate as the mortality rate in your U.S. region (per 100,000 births)?

Below 10
Between 11–15
Below 16–20
Over 20

Answer:

In 2022, the average U.S. maternal mortality rate of 23.5 per 100,000 births was significantly higher than other high-income countries, including Canada, Australia, and western Europe, which are typically below 10. Here are recent U.S. rates.

Maternal mortality rates by U.S. region, per 100,000 births:

  • Northeast – 19.2
  • Midwest – 21.0
  • South – 33.9
  • West – 20.2

Question 2: Maternal Morbidity

Maternal morbidity refers to complications during pregnancy, childbirth, or the postpartum period. These can include near-death (near-miss) events, significant health consequences, or unexpected health conditions complicating a pregnancy, birth, or maternal well-being. What do you estimate as the maternal morbidity rate for your region (per 10,000 births)?

Less than 50
Between 51–100
Between 101–150
Over 150

Answer:

In 2016-17 (the most recent years for which the CDC has published detailed maternal morbidity data), approximately 1.4% (or 140 per 10,000) of those giving birth in the U.S. experienced severe maternal morbidity. As many as 60,000 U.S. birthing persons experience maternal morbidity each year. These conditions correlate to race/ethnicity, with Black patients experiencing more than double the rate of maternal morbidity as non-Hispanic whites.

Maternal morbidity rates by U.S. region, per 10,000 births:

  • Northeast – 173 (about 1.7%)
  • Midwest – 110 (about 1.1%)
  • South – 147 (about 1.5%)
  • West – 132 (about 1.3%)

Question 3: Caserean Sections

Higher rates of C-sections can increase maternal risk. What do you estimate as the percentage of C-sections of all births in your U.S. region?

Below 20%
Between 20–30%
Over 30%

Answer:

Research has shown that C-section delivery rates up to approximately 19% are associated with lower maternal mortality, but higher C-section rates correlate with increased maternal mortality and morbidity. Regional U.S. C-section rates can reflect differences in practices, policies, and patient demographics.

C-section rates by U.S. region:

  • Northeast – 31.6%
  • Midwest – 29.0%
  • South – 33.9%
  • West – 27.0%

Question 4: Leading Causes of Maternal Mortality

Potentially life-threatening causes of maternal mortality include a range of factors. What was the leading cause of maternal deaths in the U.S., as reported by Maternal Mortality Review Committees (MMRCs) in 36 states from 2017-19?

Cardiac or coronary conditions
Embolism
Hemorrhage
Hypertensive disorders of pregnancy
Infections
Mental health conditions

Answer:

Mental health conditions were the leading reported cause of maternal death, followed by hemorrhage, cardiac or coronary conditions, and infections.

Leading causes of U.S. maternal deaths:

  • Mental health conditions – 22.7%
  • Hemorrhage – 13.7%
  • Cardiac and coronary conditions – 12.8%
  • Infections – 9.2%
  • Embolism (thrombotic) – 8.7%
  • Cardiomyopathy – 8.5%
  • Hypertensive disorders of pregnancy – 6.5%
  • Embolism (amniotic) – 3.8%
  • Injury – 3.6%
  • Cerebrovascular accident – 2.5%
  • Cancer – 1.9%
  • Other conditions – 2.4%

It is important to note that the MMRCs determined that over 84% of the reported maternal deaths were preventable. Leading causes of death varied by race and ethnicity.

Question 5: Other Key Factors Affecting Maternal Care

Additional key factors can be clear indicators of maternal care quality. Which of the following should be focus areas for your health system or hospital?

Prenatal care
Patient experience
Evidence-based practices
Readmission rate
Neonatal mortality
Newborn health

Answer:

Using measures for all these areas as part of a combined maternal and neonatal composite score — or perinatal quality indicator (PQI) — can provide an overall assessment of obstetric care quality at your healthcare organization or practice.

  • Prenatal care — Timeliness and consistency of early and adequate prenatal care
  • Patient experience — Survey and feedback results about patients’ care experience, including aspects such as communication, respect, and support during labor and delivery
  • Evidence-based practices — Adherence to guidelines and best practices, such as the use of appropriate interventions during labor and delivery
  • Readmission rate — Return of patients to the hospital after discharge, indicating possible issues with the initial care or complications arising after discharge
  • Neonatal mortality — Number of deaths of infants within the first 28 days of life per 1,000 live births
  • Newborn health — Assessments such as preterm birth rate, low birth weight rate, Apgar scores, NICU admissions, and breastfeeding initiation rate, which can indicate health complications, issues with maternal nutrition, or inadequate prenatal care

How Relias can help

Every obstetric provider and clinician serves an important role in preventing maternal mortality and morbidity and improving patient outcomes. Relias OB courses focus on clinical risk areas and include Fetal Heart Monitoring, Obstetric and Postpartum Hemorrhage, Hypertensive Disorders in Pregnancy, Shoulder Dystocia, Promoting Vaginal Birth, and Maternal Sepsis.

Our award-winning, Jointly Accredited Relias OB education provides competency development and continuing education for healthcare teams to reduce variation, elevate quality, and improve care.

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