A review of maternal mortality and quality of care in the USA

Abstract

Objective: The purpose of this study was to review studies and reports examining maternal mortality and quality of maternal health care in the USA, which has the highest maternal mortality rate among its peers.Methods: Electronic search of current literature on maternal mortality and quality of care in the USA and Europe was conducted. Findings were summarized according to the Donabedian's structure-process-outcomes conceptual model.Results: Standards and protocols, effective communication and hospitalist care indicated positive maternal outcomes, including a reduction in maternal mortality. However, lack of coordination of care among providers for pregnant women with chronic disease, fragmentation, or substandard of care and late prenatal care initiation are among the domain of processes of care that were noted to negatively influence maternal health outcomes. Further, the absence of a national forum committee to gather and systematically use research findings and data to guide change constitutes a serious obstacle in improving quality of care in the obstetric field.Conclusions: Providing good quality of care and eliminating health disparities in obstetrics and gynecology are important elements in preventing maternal deaths. Future research regarding patient-centered care and health disparities in maternal health will provide guidance to policymakers in our efforts to reduce maternal mortality.

Keywords: Coordination of care; maternal health; maternal morbidity; obstetric care; prenatal care.