A Roadmap for Non-traditional Interventions to Address Maternal Mortality and Morbidity

Project: Research project


Women’s voices in reproductive health care, from preconception and prenatal through postpartum care, represent a missing piece in the information being brought to bear on the crisis of maternal mortality and morbidity. The overall increase in maternal mortality, as well as the alarming discrepancy in morbidity and mortality between white women and women of color, highlight the need for research and interventions that examine and target previously neglected factors within and beyond health care setting. Community support services, family interactions, patient-provider relationships and life style considerations are critical both in reproductive health planning and following a high-risk pregnancy, birth, or a severe maternal morbidity. Factors in these domains likely impact women’s choices that contribute to poor maternal outcomes for first time and repeat pregnancies. This contract will begin a program of research and intervention development targeting maternal mortality and morbidity.

While clinicians play an essential role in improving maternal safety during prenatal care, labor & delivery, and postpartum care, women and their partners are also critical. Yet women’s opinions and experiences are often excluded from the conversations and strategic planning theoretically designed to improve their lives. In particular, women of color, low income women, as well as women who speak Spanish and/or live in rural areas are more likely to experience health inequity than other women. They are also less likely to have their opinions heard when decisions about services and programs are being made. As efforts by Merck for Mothers, AMCHP and others, alongside clinicians and health systems, lead the charge towards reducing maternal mortality and morbidity, it is important that the opinions and experiences of women are included. Given the historical disparities in health outcomes in the South, along with the resilience and diversity of the women who live there, we believe the southeast is a prime location to broaden the dialogue and discover new strategies and solutions to the growing maternal mortality and morbidity problem. In addition, it is important to understand exactly what the state of the science is regarding social factors contributing to maternal mortality and morbidity. Accordingly this contract will focus on the following specific tasks:

• Following the development of specific research hypotheses, we will undertake a systematic review of the extant literature to understand clearly what is known and not known about non-traditional intervention targets for addressing maternal mortality and morbidity. This review will be done according to PRISMA standards creating a high quality synthesis to guide future work.

• Develop a road map document that moves the systematic review into the realm of action research. This document will specify intervention areas to be considered for future development suggested by the review.

• Convene a panel that brings together women from various communities together with experts in maternal fetal medicine, maternal mortality (NC and GA teams), public health, social work, and AMCHP to discuss and augment the road map, and plan next steps. It is critical that patient voices be a part of this panel. We will work with local women’s advocacy groups to identify women who may be willing to participate and provide a patient perspective. We will carefully connect and link this to the Every Mother Initiative.

• Out of this work, we will plan for a more extensive intervention development and testing project.
Effective start/end date11/1/148/31/15


  • Association of Maternal and Child Health Programs (AMCHP)


Maternal Mortality
Postnatal Care
Reproductive Health
Delivery of Health Care
High-Risk Pregnancy
Health Planning
Prenatal Care
Social Welfare
Health Services Research
Social Work
Postpartum Period
Life Style