Comparable Healthy People 2010 Objective:
Adapted from HP2010 objective
Data Collection Frequency:
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.
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.