Despite tremendous improvements in perinatal care and health care in general, pregnancy continues to pose a risk for death. Since 1982, the maternal mortality rate, both nationally and in New Jersey, has remained at a relatively constant level, and racial and ethnic disparities continue to exist. Over the past nine years NJ has taken an active role in examining maternal mortality and trying to find answers to why women continue to be at risk for death through examination of the systems and services that affect women during their pregnancy. Recognition of the mortality review process by healthcare professionals and facilities statewide continues to grow and the results of the abstractions are now being shared with interested individuals and organizations to help facilitate change and promote positive outcomes to pregnant women in NJ. 

The key elements incorporated into the review process are the reporting of maternal deaths, including use of multiple database matching strategies; consistent methods of data abstraction; review of cases by a multidisciplinary team; integration of the CDC’s expanded definition; trending of data from year to year; and integration of findings into quality improvement activities. Cases are identified by direct reporting of a maternal death by a hospital, medical examiner or other personnel to the New Jersey Department of Health and Senior Services (NJDHSS); a death certificate which indicates the woman was pregnant within 90 days prior to death; a linkage of death certificates; live birth and fetal death records; and the hospital discharge file using a probabilistic methodology conducted by the NJDHSS MCH Epidemiology Program.

The NJ Maternal Mortality Review program is a dynamic, evolving process which holds much promise for the women of NJ.  Through the findings and recommendations of the Case Review Team we encourage practitioners and healthcare facilities to integrate into their practice changes that can ensure the health and wellbeing of the women they serve.  By sharing both the challenges and the triumphs of our experience we hope to facilitate improvement in the system of care and a better understanding of the incidence and circumstances surrounding pregnancy-associated deaths.