JEFFERSON CITY, MO — The Missouri Department of Health and Senior Services (DHSS) has published A Multi Year Look at Maternal Mortality in Missouri: 2017-2021 Annual Report on behalf of the state’s Pregnancy-Associated Mortality Review (PAMR) Board, a multidisciplinary board of experts from across the state tasked with examining the causes and contributing factors associated with maternal mortality and ultimately forming recommendations that could prevent these deaths from occurring in the future.
The report is an aggregate of five years’ worth of work of the PAMR Board and is based upon the most recent data available. This is the first time a continuous five-year aggregate has been available for analysis as PAMR was formed by legislative action in 2019.
The 2017-2021 report contains data, including the timing and leading causes of pregnancy-related deaths, and factors that contributed to these deaths, such as mental health conditions and substance use disorders. The report also reflects the disparities that exist in our state and among our most vulnerable populations, including our Black and publicly insured communities. Finally, the report includes recommendations by the Board for a variety of stakeholders including lawmakers and health care providers.
Analysis of data and related patient records indicates cardiovascular diseases were the leading underlying cause of pregnancy-related deaths, followed by mental health conditions (including substance use disorders). An average of 70 Missouri women died while pregnant or within one year of pregnancy each year over 5 years (2017-2021), with the highest number recorded in 2020 (85 deaths).
Other key findings include the following:
From 2017-2021 (349 deaths total):
- The pregnancy-related mortality ratio was 32.2 deaths per 100,000 live births.
- The pregnancy-related mortality ratio for Black women was 2.5 times the ratio of white women. This is a decline from the previous three reports.
- All pregnancy-related deaths due to mental health conditions, including substance use disorder, were determined to be preventable. 77% percent of all pregnancy-related deaths were determined to be preventable.
- Almost half (44%) of all pregnancy-related suicides over five years (2017 to 2021) occurred in 2020.
- COVID-19 was the cause of death for 2 in 3 pregnancy-related deaths due to infection in 2021.
- Women living in micropolitan counties had the highest ratio of pregnancy-related deaths (38 per 100,000 live births). Prior reports found women living in metropolitan counties had the highest ratio.
In 2022, DHSS led the nation by publishing the first statewide, interactive dashboard displaying maternal mortality data.
In December 2023, Governor Parson announced that DHSS would lead efforts with new funding and partnerships to reduce maternal mortality in Missouri. Since then, additional declarations of support and financial investment in Missouri mothers have been made with bipartisan legislative support.
“We are expeditiously implementing the agreed-upon strategies to reduce maternal mortality with the funding recommended by the Governor and appropriated by the General Assembly. It is reassuring that our state’s policymakers understand the gravity of this issue and were willing to take decisive action,” said DHSS Director Paula F. Nickelson. “Highlighting the work of the PAMR Board through the dashboard and this thorough annual report allows our team and stakeholders a more effective tool to monitor progress as various evidence-driven initiatives are implemented statewide to address our unacceptable maternal mortality rates in Missouri.”
The 2017-2021 annual report can be viewed at Health.Mo.Gov/data/pamr.
