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MICH-5 Data Details

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MICH-5 Reduce the rate of maternal mortality

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Vital Statistics System-Mortality
National Vital Statistics System-Natality
Changed Since the Healthy People 2020 Launch: 
No
Measure: 
per 100,000 live births
Baseline (Year): 
12.7 (2007)
Target: 
11.4
Target-Setting Method: 
10 percent improvement
Numerator: 

Number of female deaths due to obstetric causes (ICD-10 codes A34, O00-O95, O98-O99) within 42 days of a pregnancy

Denominator: 

Number of live births

Comparable Healthy People 2010 Objective: 
Adapted from HP2010 objective
Data Collection Frequency: 
Annual
Methodology Notes: 

    The maternal mortality rate indicates the likelihood of a pregnant woman dying of maternal causes. It is calculated by dividing the number of maternal deaths in a calendar year by the number of live births registered for the same period and is presented as a rate per 100,000 live births. The number of live births used in the denominator is an approximation of the population of pregnant women who are at risk of a maternal death. “Maternal deaths” are defined by the World Health Organization as "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes." Included in these deaths are ICD–10 codes A34, O00-O95, and O98-O99.

Caveats and Limitations: 
The 2003 revision of the U.S. Standard Certificate of Death introduced a checkbox question format with categories to take advantage of additional codes available in ICD–10 for deaths with a connection to pregnancy, childbirth, and the puerperium. As states revise their certificates, most introduced the standard item or replace pre-existing questions with it, allowing for wider adoption of a pregnancy status item nationwide and greater standardization of the particular item used. As of 2007, 34 states and the District of Columbia had a separate question related to pregnancy status of female decedents around the time of their death, and 2 states had a prompt encouraging certifiers to report recent pregnancies on the death certificate. However, at least six different questions were used in the 34 states, reflecting the mix of states using the 2003 standard format and states with pre-existing questions.
Trend Issues: 
The 2007 baseline was calculated including data supplied by states that had adopted the 2003 version of the U.S. Standard Certificate of Death. Trends over time cannot be evaluated until all states implement the 2003 Standard Certificate and provide data in the same format. Adopting a pregnancy status question consistent with the standard death certificate increases the identification of maternal deaths. Maternal mortality rates are consistently greater for those states with the additional information from the separate question than for the states without it. In addition, state maternal mortality rates tend to be greater after adopting the standard question than before. Some research on this issue indicates that this increase represents an improvement in identifying maternal deaths. However, growing evidence suggests the pregnancy status question may increase false reporting of recent pregnancy, especially with increasing age. This may result in overreporting of maternal deaths.
Changes Between HP2010 and HP2020: 
This objective differs from Healthy People 2010 objective 16-4 in that for Healthy People 2020, states have been encouraged to adopt the 2003 revision of the U.S. Standard Certificate of Death, which includes an item on the pregnancy status of female decedents.