PHILADELPHIA–The Philadelphia Maternal Mortality Review Committee published a report that found that Philadelphia’s rate of pregnancy-related deaths from 2013 to 2018 was approximately 20 per 100,000 live births, which is higher than the 2018 national rate of 17.4 per 100,000 live births. Non-Hispanic Black women made up 43% of births in Philadelphia from 2013-2018 but accounted for 73% of the pregnancy-related deaths. Deaths due to accidental drug overdoses increased from 25% of Philadelphia’s pregnancy-associated deaths (from 2010 to 2016) to 39% (from 2017 to 2018). The Review Committee cautioned that the pregnancy-associated deaths described in this report are just the tip of the iceberg when looking at the overall state of maternal health in Philadelphia.

“In order to meaningfully reduce maternal mortality, it is necessary to work collectively, think outside the box and develop innovative solutions,” said Aasta D. Mehta, MD, MPP, Medical Officer of Women’s Health at the Philadelphia Department of Public Health, and Director of the Philadelphia Maternal Mortality Program. “Significant racial disparities in maternal health outcomes demand attention to the underlying issues, which should be accomplished by addressing implicit bias and systemic racism. Devoting resources to address social determinants of health and integrating community voices into policies and programs is key to improving the maternal health outcomes for the women of Philadelphia and across Pennsylvania.”

The MMRC collected recommendations developed during each MMRC meeting in response to each case. These recommendations fit into seven broad themes that are presented in the Improving Outcomes: Maternal Mortality in Philadelphia report as overarching recommendations to help improve maternal mortality in Philadelphia. The recommendations are:

  1. Address root causes of health inequity in the healthcare system
  2. Tailor behavioral and mental health services to meet the specific needs of pregnant and postpartum women
  3. Improve access to preventive, preconception, and prenatal care
  4. Direct more attention to the postpartum period
  5. Heighten awareness of high-risk pregnancy and postpartum complications in non-obstetric care settings
  6. Strengthen coordination of services between healthcare and social service settings
  7. Build infrastructure to identify and support women with history of intimate partner violence

The Improving Outcomes: Maternal Mortality in Philadelphia report was developed using aggregated data from 110 pregnancy-associated and pregnancy-related deaths in Philadelphia between 2013 and 2018. The report can be downloaded from the Health Department’s Data website.

Philadelphia has been a leader in addressing maternal mortality by creating the nation’s first non-state-based MMRC in 2010. The Philadelphia MMRC gathers multidisciplinary stakeholders from across the city in order to better understand the causes of maternal mortality and to provide recommendations for policy and programmatic change. Comprising representatives from the five labor-and-delivery hospitals in the city, along with members from city agencies and non-governmental organizations, in order to identify, track, and review its pregnancy-associated deaths. This, in turn, has helped Philadelphia identify gaps in local healthcare systems and community resources that have contributed to pregnancy-associated deaths. The process has helped focus limited resources to address these issues, with a goal of reducing maternal mortality and improving overall maternal health and well-being.