Maternal Mortality Toolkit

Maternal mortality is a critical global health issue, highlighting disparities in healthcare access and quality.

It is defined as the death of a woman during pregnancy, childbirth, or within 42 days of delivery.
Maternal mortality is a key indicator of a nation's overall health system.
In 2020, approximately 287,000 women died during and following pregnancy and childbirth according to the World Health Organization.
The majority of these deaths occur in low-resource settings and are largely preventable.

Reducing maternal mortality involves:

Improving access to quality healthcare services.
Ensuring the presence of skilled health professionals during childbirth.
Addressing broader social determinants such as poverty, education, and gender inequality.
Focusing on these areas can help reduce maternal deaths and promote a safe and healthy future for mothers and their children worldwide.

Perinatal Mood & Anxiety Disorders (PMADs) encompass a range of emotional and mental health conditions that can affect women during pregnancy and after childbirth. These disorders include postpartum depression, anxiety, obsessive-compulsive disorder, and, in severe cases, postpartum psychosis. PMADs can cause significant distress, impacting a mother's ability to function and bond with her baby. Symptoms may include persistent sadness, intense anxiety, irritability, changes in sleep or appetite, and intrusive thoughts. The exact causes of PMADs are not fully understood, but they are thought to result from a combination of hormonal changes, genetics, and environmental factors. It's essential for women experiencing these symptoms to seek help, as effective treatments are available to support recovery and promote well-being for both mother and child. See more informational resources about PMADs below:

Intimate Partner Violence (IPV) during pregnancy is a serious issue that can have severe consequences for both the mother and the unborn child. Pregnant women experiencing IPV may face physical injuries, psychological trauma, and heightened stress, which can lead to complications such as preterm labor, low birth weight, and miscarriage. The abuse can include physical violence, emotional manipulation, financial control, and isolation. Beyond the immediate physical risks, IPV can cause long-term psychological effects, including anxiety, depression, and post-traumatic stress disorder (PTSD). The presence of IPV also complicates the healthcare and support women receive, as fear of the abuser or stigma may prevent them from seeking necessary medical care. It is crucial for healthcare providers and support networks to recognize and address IPV in pregnant women to ensure their safety and well-being. See more informational resources about IPV below:

Screening tools are essential for physicians to identify Perinatal Mood & Anxiety Disorders (PMADs) and Intimate Partner Violence (IPV) among pregnant and postpartum women. These tools, such as standardized questionnaires and interviews, help healthcare providers assess the mental and emotional well-being of their patients, ensuring early detection and intervention. For PMADs, screenings can identify symptoms of depression, anxiety, and other mood disorders, allowing for timely treatment and support. In the context of IPV, screening tools can uncover signs of abuse, enabling healthcare professionals to offer resources and safety planning. The use of these screening tools is crucial in providing comprehensive care, promoting the health and safety of both the mother and her child. See below for PMAD & IPV screening tools:

Handling Positive Screens:

If a patient screens positive for EPDS (Edinburgh Postnatal Depression Scale):

Immediate Action for Suicidality: Refer the patient to the emergency room if they exhibit signs of suicidality.
Mental Health Support: For patients overwhelmed by their mental health, extremely upset, or anxious, providers can use the Virginia Community Service Boards (CSBs) to connect the patient with local mental health resources. More information can be found at the Virginia Department of Behavioral Health and Developmental Services.

If a patient screens positive for HITS (Hurt, Insult, Threaten, Scream) indicating potential intimate partner violence (IPV):

Immediate Response: Providers can call the Virginia statewide hotline at 1-800-838-8238 to connect the patient with an advocate from the Virginia Sexual and Domestic Violence Action Alliance. More information is available on their website.
Crisis Response for IPV: If the patient is in immediate crisis and needs alternate housing, advocates will assist in finding short-term solutions such as staying with a family member or friend, arranging a bus ticket to stay with family, or, as a last resort, offering shelter or hotel accommodations.
Non-Crisis Response for IPV: If the patient is not in immediate crisis, advocates will work with them to develop a safety plan and connect them with local resources for ongoing support.