Maternal Morbidity and Mortality
Each year, more than 50,000 women in the United States experience severe maternal morbidity (SMM), or unexpected outcomes of labor and delivery. (Centers for Disease Control and Prevention)
More than 700 women in the United States die annually as a result of pregnancy or delivery complications out of approximately four million births each year. (US Health Resources & Services Administration)
PCORI has awarded more than $150 million to fund more than 70 research and engagement projects to address maternal mortality. (As of July 2022)
PCORI Funding Announcements (PFAs)
View open and previous PFAs for research studies focused on, or related to maternal health and maternal healthcare.
LOIs Under Review: Partner Targeted PFA
Seeks proposals to address social and clinical determinants of maternal health.
Closed PFA: Broad Pragmatic Studies
Included Special Area of Emphasis on optimizing prevention and treatment of postpartum hemorrhage.
Closed PFA: Improving Postpartum Maternal Outcomes for Populations Experiencing Disparities
Sought proposals to improve early detection of, and timely care for, risk factors for postpartum complications.
2022 PCORI Annual Meeting Breakout Session Spotlight
Addressing Social and Structural Determinants of Maternal Health
This session aimed to provide a better understanding about the barriers researchers and stakeholders face in addressing social and structural determinants of health with relation to maternal health outcomes, and to hear ways in which PCORI and others can address these barriers and meaningfully include the communities' experiencing disparities in research on strategies to improve maternal health outcomes.
Spotlights: Ongoing Studies and Projects
Black Midwives for Black Women: Maternity Care to Improve Trust and Attenuate Structural Racism
Historical racism in health care has contributed to barriers in access to quality care and higher levels of distrust among Black women toward the health care system. The research study team is testing a program called Melanated Group Midwifery Care, which aims to improve the care Black women receive before and after giving birth.
Reducing Racial Disparities in Maternal Care through Data-based Accountability and Doula Support
The research study team is seeking to decrease pregnancy complications for all patients, but especially for Black patients, by decreasing institutional racism and bias in health care and improving community-based social support during pregnancy.
Comparing Methods for Treating Depression and Anxiety among Pregnant and Postpartum Women
Talk therapy is effective for treating depression and anxiety, and women often prefer it over medication. The research study team is comparing the effectiveness of behavioral activation (BA), a form of talk therapy, provided by a mental health professional versus a nurse or midwife, in addition to the comparison of in-person BA with BA given through telemedicine, or by videoconference.
Engaging Stakeholders in Perinatal Depression Research in the Context of COVID-19
Depression can be a major pregnancy complication that can cause adverse outcomes for both mothers and their infants if left untreated. This engagement project will explore ways to engage participants in patient-centered and clinical effectiveness research and build the capacity to engage stakeholders in the research process.
Bridging the Chasm between Pregnancy and Women’s Health over the Life Course
Women with gestational diabetes (GDM) and other pregnancy complications have a high risk for chronic illnesses in later life. This engagement project uses GDM as a case in point to galvanize diverse stakeholders to build systems-based bridges addressing the fragmentation in women’s health care.
Partnering with Community Doulas to Improve Maternal and Infant Health Equity in California
Doulas are trained professionals who provide educational, physical, and spiritual support before, during, and after childbirth, and they are often associated with improved maternal and infant outcomes. This engagement project is creating a collaborative of stakeholders in California to facilitate equitable, ethical, and patient-centered outcomes research on community doula care.
Blog: Improving Maternal Health Through Engagement
Did you know cardiovascular disease is a high-risk factor for pregnant women? As we mark Women's Health Month in May, read about two PCORI-funded Engagement Award project teams that are engaging a range of voices to better understand how cardiovascular disease impacts maternal health.
Telehealth Strategies for the Delivery of Maternal Health Care: A Rapid Review
PCORI commissioned a rapid review to assess evidence on the effectiveness of telehealth strategies for the delivery of maternal healthcare. Because telemedicine has experienced a swift and widespread adoption in the United States, PCORI sought to understand the evidence base on a compressed timeline in order to inform our future research investments.
The evidence synthesized in this rapid review indicates that telehealth for maternal health care delivery is a promising alternative and/or supplement to usual, in-person care. Equally important are the evidence gaps identified in this review that point us to future research priorities. Full results of this rapid review are also available in the Annals of Internal Medicine.
Study Results that Support Better-Informed Decisions
Testing the Effectiveness of Adding Group Therapy to Home Visiting Services on Reducing Postpartum Depression in Women with Low Incomes: A Randomized Controlled Trial
Adding a group therapy program called Mothers and Babies to home visiting services did not reduce depressive symptoms in perinatal women more than home visiting services alone, according to this PCORI-funded research study.
However, group therapy led by a community health worker was comparably effective as group therapy led by a mental health professional in reducing depressive symptoms. The study included 824 perinatal women enrolled in 37 home visiting programs in seven midwestern states. The trial results were published in the Archives of Women’s Mental Health in March 2021.
Read more about the study in this PCORI Story and watch a video interview with Darius Tandon, the study’s Principal Investigator, in which he shares more about his study and reasons why women are not receiving care for postpartum depression.
Can an Online Program Help Women with a History of Preeclampsia Reduce Their Risk of Heart Disease? A Randomized Controlled Trial
Health 4 Moms, an online intervention designed for and by women with a history of preeclampsia to improve healthy lifestyle choices improved patients’ knowledge of heart disease risk, self-efficacy to achieve a healthy diet, and reduced physical inactivity among women with recent preeclampsia, according to this PCORI-funded research study.
The study enrolled 151 mothers nationwide with recent preeclampsia. The trial results were published in the Journal of Women's Health in July 2019.
PCORI Systematic Reviews Related to Maternal Health
PCORI has commissioned several reviews through the Agency for Healthcare Research and Quality (AHRQ) with the goal to produce up-to-date, actionable evidence to inform important healthcare choices.
Congress Identifies Maternal Morbidity and Mortality as Research Priority
As part of the 2019 legislation that reauthorized PCORI’s funding for 10 years, Congress included research on maternal morbidity and mortality as a priority research topic.
The Intersection of Cardiovascular Disease and Maternal Morbidity
Executive Director Nakela L. Cook, MD, MPH, shares PCORI’s focus on maternal morbidity and mortality at the intersection of cardiovascular disease and reaffirms PCORI’s commitment to funding actionable projects to improve patient outcomes and reduce cardiovascular complications of pregnancy and maternal mortality in the United States.
The Intersection of Cardiovascular Disease and Maternal Morbidity
Overview of PCORI's Work on Reducing Maternal Morbidity and Mortality -- Board of Governors Meeting (March 8, 2022)
2021 PCORI Virtual Annual Meeting Breakout Session: Awareness and Opportunity -- Meaningful Stakeholder Engagement for Equitable Maternal Health Outcomes
Additional Studies and Projects
View a selection of additional PCORI-funded research studies and Engagement projects that focus on maternal morbidity and mortality.