Our nation’s maternal health statistics represent nothing short of a health care crisis. Despite our unparalleled clinical expertise and research infrastructure, the U.S. continues to have the highest maternal mortality rate in the developed world. And this alarming trend fuels AMA’s efforts to improve maternal health through community partnerships, initiatives and advocacy.
The latest figures from the Centers for Disease Control and Prevention (CDC) paint a grim picture. In 2023, the maternal mortality rate in the U.S. was nearly 19 maternal deaths for every 100,000 live births. For Black women, the statistics are even more devastating, with maternal mortality (50.3 deaths per 100,000 live births) more than three times higher than white women.
Most staggering of all, more than 80% of maternal deaths in the U.S. are preventable.
The AMA has a deep and longstanding commitment to maternal health. Decades of work have taught us that maternal mortality is a complex issue driven by social, economic, and systemic factors. Clinical factors such as hypertensive disorders and cardiac conditions, as well as barriers to comprehensive prenatal and postpartum care, all play significant roles in maternal health.
Role of social determinants of health
The AMA Center for Optimal Health Outcomes is accelerating efforts to address these root issues, in part by forging partnerships across the 200-plus physician organizations that comprise the Federation of Medicine. Research underscores the role of that social determinants of health, such as housing instability, food insecurity, lack of insurance, and bias within care delivery, in poor health outcomes.
Access to care remains a fundamental challenge. More than 2.2 million women of childbearing age in the U.S. live in maternity care deserts, defined as counties with no hospitals offering obstetric services or birth centers, as well as no obstetricians, gynecologists or certified nurse midwives. The fact that more than one-third of all U.S. counties meet that description is a key factor driving our alarming maternal mortality rate. This lack of access is felt acutely in both under-resourced cities like my hometown of Flint, Michigan, and also rural communities.
Designing and implementing a localized, grassroots effort to improve maternal health is just one example of the potential areas of focus through a newly launched AMA initiative: Community Health Impact Lab micro grants. This $1 million effort will empower physicians to break down the barriers they see in their communities with local, creative, and measurable responses. Applications are now available for up to 20 micro grants of $50,000 each.
Open to actively licensed physicians nationwide, this effort is intended to produce innovative solutions led by those who know their communities best: front-line physicians. To learn more, please join us for a webinar set for 11 a.m. CST on Tuesday, Dec. 15. You can register here.
Addressing workforce issues
Knowledgeable, well-supported clinicians are at the heart of effective maternity care. The AMA strongly supports legislation pending in Congress to add 14,000 Medicare-funded graduate medical education slots over the next seven years, which would place more physicians in more communities, in the specialties and locations where they are needed most.
We are also working to expand specialty programs such as the Maternal Health and Obstetrics Pathway, the Teaching Health Center Graduate Medical Education Program, and the National Health Service Corps’ Maternity Care Target Area initiative.
Improving data collection
Quality improvement must rest on relentless measurement and transparency. A persistent barrier to progress has been the lack of standardized definitions for maternal morbidity, severe maternal morbidity, and maternal mortality. The AMA urges federal and state agencies to adopt uniform, evidence-based definitions that will provide more accurate data, focused research, and targeted interventions.
Expanding the CDC’s Pregnancy Mortality Surveillance System and harmonizing maternal and infant health records will help drive the next generation of effective health policy. Trust in these efforts means safeguarding patient privacy and data security at every step.
Reimbursement models must evolve to reflect the complexity of maternal health. Reimbursement must reflect additional services provided in high-risk pregnancies and for chronic conditions, and the difficulty of maintaining access in rural settings. The AMA is urging CMS to adopt transformative reforms—including the Acute Unscheduled Care Model—to ensure sustainable, high-value care.
To be fully effective, these programs should include adequate funding and meaningful involvement by physicians on the front lines.
Legislative solutions
At a time when bipartisan support for legislative change is essential, the Connected Maternal Online Monitoring Act (PDF) stands out as a crucial piece of pending legislation. The Connected MOM Act will strengthen Medicaid coverage for remote monitoring devices, standardize telehealth resources, and align best practices across states to reduce maternal deaths. The AMA urges Congress to act promptly, recognizing that policy change is foundational to every successful clinical and population health intervention.
The AMA also is working to ensure permanent coverage and fair reimbursement for telehealth services, so that pregnant and postpartum patients receive timely, high-quality medical assessments and management, no matter where they live.
None of these actions alone will bring U.S. maternal mortality rates into line with peer nations. But together—through robust advocacy, innovative partnerships, and a shared pursuit of improved access to high quality health care—they offer a path forward. The AMA calls upon Congress, state legislatures, payers, hospital and health system leaders, researchers, community groups, and every individual concerned to join us in this urgent work.
Every birth in America should be safe, and every mother and baby should leave the hospital with the promise of health, hope and opportunity. It is time we work together to make a meaningful difference cutting the unacceptably high rate of U.S. maternal mortality.
