Introduction
Maternal death is the death of a woman occurring while pregnant or within 42 days of termination of pregnancy. It results from some cause related to or aggravated by the pregnancy or management but not from an accident or accidental reason. Maternal deaths are divided into two groups, the first directly related to obstetric causation. The second category of maternal deaths is indirectly related to obstetric causes due to diseases already present in the woman or during pregnancy (Hill et al., 2007). It is significant to mention that it is not related to obstetric reasons, but the physiological effects of pregnancy aggravate it. Thus, the risk group includes females who are carrying or giving birth to a child.
The maternal mortality rate is one of the main criteria of socio-economic development of society, quality, and level of organization of obstetric institutions. In addition, the effectiveness of introducing scientific achievements into health care practice. Maternal mortality is the most significant indicator of the health of female reproductive age, but its level is still high (Davis et al., 2019). Every day about 800 women worldwide die of complications related to pregnancy or childbirth. In 2017, 281,000 women lost their lives during and after pregnancy and childbirth, with most of the deaths occurring in developing countries, especially since most of them were preventable (Creanga, 2018). The U.S. ranks 60th in the world for maternal deaths, ahead of all developed countries. According to the researcher, U.S. maternal mortality indicators are consistently worse than in many other advanced nations. For instance, maternal mortality rates in the U.S. are 3 times higher than in the United Kingdom and 8 times higher than in Iceland (Neggers, 2016). Maternal mortality is an issue that scientists have been researching for decades, but there is still no consensus on its reasons and prevention methods.
Literature Review
The article by Creanga (2018) provides an overview of maternal mortality data and its limitations in the United States. The article applies a quantitative data analysis method to national mortality statistics and the maternal death surveillance system. It is established that poor quality of medical care, limited access to childbirth services, and unfavorable socio-economic circumstances contribute to mortality (Creanga, 2018). The paper contributes significantly to understanding the reasons for maternal deaths, which affects the formation of strategies to address the challenge. The article describes that risk elements can be changed through medical care, teaching, or social approval systems. The dangerous factors were obesity, age beyond 39 years, and chronic diseases (Goffman et al., 2007). It is valuable to this article that the risk factors have been categorized according to racial criteria. Collier and Molina (2019) try to explain the growing maternal mortality rate in the United States. At the same time, they argue that measures to enhance safety and quality of care during pregnancy, childbirth, and postpartum are essential for better maternal health.
Lister et al. (2019) explore the factors responsible for the increase in black maternal mortality. It found that a multilevel approach involving the patient, provider, and public health policy can reduce mortality rates. It is essential to mention that the study by MacDorman et al. (2016) examined maternal mortality in the United States from 2000 to 2014. It is indicated that California demonstrated a decreasing trend and Texas an improving one. Nove et al. (2014) considers adolescents’ increased maternal mortality rate. The study by McAlister & Baskett (2006) showed that women’s literacy status and cumulative enrollment in educational programs affected maternal death levels. Therefore, strategic investments to improve quality of life through women’s education will reduce maternal mortality rates.
Research Question
Research Question: What are the causes of the higher maternal mortality rate and the solutions to address these problems?
In the United States, the deaths of women during pregnancy or childbirth are extending. Pregnancy-related deaths in the United States have grown during the past three decades. It is worth noting that some experts attribute women’s social and economic status, including education, as influencing variables. The significant and persistent differences in maternal mortality rates are also associated with race and ethnicity. Maternal deaths among blacks are 55 per 100,000 births, nearly three times higher than among whites (Creanga, 2018). Accordingly, the causes of the increased maternal mortality rate should be identified, and methods to combat it developed.
Methodology Analysis
Notably, the study will focus on the female population who live in the United States. This is explained by the fact that maternal mortality rates in the United States are continuously increasing. Thus, the research will describe the U.S. female population that has been at risk and affected during pregnancy and childbirth, resulting in maternal mortality. The research will analyze data available through government agencies to gather reliable information. Accordingly, the study will use reports provided by 14 state MMRCs through the Maternal Mortality Review Information Program (MMRIA) (Pandey & Pandey, 2021). This program was selected because it contains a complete record of the woman carrying the baby and the physicians who accompanied the pregnancy.
Therefore, data on the mother’s condition will be collected, and the physician who provided her treatment will be invited to the interview. To verify enough data, the study will analyze reports and interviews of doctors commenting on maternal deaths from 2008 to 2017. Significantly, the study is limited to the states of Arizona, Colorado, Delaware, Florida, Georgia, Hawaii, Illinois, Louisiana, Mississippi, North Carolina, Ohio, South Carolina, Tennessee, and Utah. Consequently, a ten-year study of maternal mortality in 14 states will establish the common and different causes of the problem. At the same time, this comprehensive research sample will assist in developing general trends and methods of addressing the issue. The study will use the snowball method, which means that the reports will be systematically verified; the first portion of respondents will be randomly selected (Pandey & Pandey, 2021). Once certain relationships have been established between physician surveys and maternal deaths of women, subsequent inclusion of deaths by a particular attribute in the sample will occur. This method of sampling is appropriate for developing specific trends.
Importantly, the women’s first and last names will not be publicly available. This is because participants in the study are guaranteed confidentiality of personal data. The study also assures the anonymity and confidentiality of the physicians involved in the interviews. Employees and interviewees will sign a nondisclosure agreement before the research is conducted. Additional financial resources and incentives for physicians will be provided. The research is scheduled for 2 months of preparation and 2 months of interviewing and studying the data. Therefore, this time is sufficient to address the ethical issues.
Statistical Data Analyses
The study will use a cross-sectional approach; this type of observational research focuses on analyzing data from different variables in a particular population collected during a specific period. Thus, the use of this method will analyze the variables and conclude the factors that influenced them. For the technique to be effective, the data collected is similar to all traits except those that need to be established. The negative side of cross-sectional analysis is that it is impossible to conduct a series of observations on a single sample (Pandey & Pandey, 2021). It should be emphasized that the primary location of the study will be Arizona.
Researchers will analyze medical records provided by 14 state MMRCs. At the same time, physicians will be interviewed to learn the details of the woman’s disease progression or cause of death. Regression analysis will summarize the results of the research reports and interviews (Oyedele, 2021). Accordingly, it will be possible to understand the relationship between the dependent and independent variables and provide an unknown value for the dependent variable (Pandey & Pandey, 2021). Therefore, the research results will establish potential trends in maternal mortality and allow for their reduction.
Conclusions
A limitation of the research is that it examines data from 14 states. It is impossible to accurately identify the same causes of maternal mortality in the United States and find a solution because of insufficient funding. However, the study aims to establish the underlying reasons for maternal mortality in the 14 states and then propose methods to address this. For instance, the research is designed to establish a connection between maternal mortality and a woman’s social and economic status. The research is needed to complement the available literature. Accordingly, the significance and relevance of this study derive from the fact that it brings together the significant findings ascertained in the literature and validates them.
References
Collier, A. R. Y., & Molina, R. L. (2019). Maternal mortality in the United States: Updates on trends, causes, and solutions. Neoreviews, 20(10), 561-574. Web.
Creanga, A. A. (2018). Maternal mortality in the United States: A review of contemporary data and their limitations. Clinical Obstetrics and Gynecology, 61(2), 296-306. Web.
Davis, N. L., Smoots, A. N., & Goodman, D. A. (2019). Pregnancy-related deaths: Data from 14 US maternal mortality review committees. Education, 40(36), 8-2.
Goffman, D., Madden, R. C., Harrison, E. A., Merkatz, I. R., & Chazotte, C. (2007). Predictors of maternal mortality and near-miss maternal morbidity. Journal of Perinatology, 27(10), 597-601. Web.
Hill, K., Thomas, K., AbouZahr, C., Walker, N., Say, L., Inoue, M., & Suzuki, E. (2007). Estimates of maternal mortality worldwide between 1990 and 2005: An assessment of available data. The Lancet, 370(9595), 1311–1319. Web.
Lister, R. L., Drake, W., Scott, B. H., & Graves, C. (2019). The Black maternal mortality-the elephant in the room. World Journal of Gynecology & Womens Health, 3(1).
MacDorman, M. F., Declercq, E., Cabral, H., & Morton, C. (2016). Is the United States maternal mortality rate increasing? Disentangling trends from measurement issues short title: US maternal mortality trends. Obstetrics and Gynecology, 128(3), 447.
McAlister, C., & Baskett, T. F. (2006). Female education and maternal mortality: A worldwide survey. Journal of Obstetrics and Gynaecology Canada, 28(11), 983-990. Web.
Neggers, Y. H. (2016). Trends in maternal mortality in the United States. Reproductive Toxicology, 64, 72–76. Web.
Nove, A., Matthews, Z., Neal, S., & Camacho, A. V. (2014). Maternal mortality in adolescents compared with women of other ages: Evidence from 144 countries. The Lancet Global Health, 2(3), 155-164. Web.
Oyedele, O. F. (2021). Extension of biplot methodology to multivariate regression analysis. Journal of Applied Statistics, 48(10), 1816-1832. Web.
Pandey, P., & Pandey, M. M. (2021). Research methodology tools and techniques. Bridge Center.