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The data presented in this dashboard below provide information on pregnancy-associated deaths, defined as the death of a woman within 365 days of the end of a pregnancy, regardless of the cause of death or the outcome of the pregnancy. Data come from the Virginia Pregnancy-Associated Mortality Surveillance System (PAMSS). Virginia’s PAMSS collects information on all pregnancy-associated deaths among Virginia residents. This surveillance system helps to identify and monitor patterns and trends related to pregnancy-associated deaths in Virginia, provides a snapshot of maternal mortality, and helps inform policy decisions of public health importance. Data from PAMSS include not only surveillance data, but also data collected from the Maternal Mortality Review Team (MMRT) process. Please refer to the 'About the Data' and 'Definitions' below the dashboard for more information.
Virginia’s MMRT is one of the longest continuously functioning multidisciplinary review teams in the United States. The MMRT was established in March 2002 as a partnership between the Offices of Family Health Services (OFHS) and the Chief Medical Examiner (OCME). The team was codified, §32.1-283.8, by the 2019 General Assembly, with the OCME continuing to provide coordination for the team. The MMRT is dedicated to the identification of all pregnancy-associated deaths in the Commonwealth and the development of recommendations for interventions to reduce preventable deaths. The team collects records including:
- Hospital records where the birth or pregnancy-related issue, concern, or termination occurred and where the death occurred
- Birth attendant’s records
- Autopsy records
- Medical Examiner case investigation records.
- Records from other health care providers and specialists, social service agencies, and mental health facilities
Reviewing these records helps to make sure that there is an in-depth understanding of the woman’s life, health, and healthcare utilization in the five years before the death. Through the review process, the team determines the community-related, patient-related, healthcare facility-related, and/or healthcare provider-related factors that contributed to the woman’s death. Consensus decision-making is used to determine whether the death was preventable and/or related to the pregnancy. The MMRT also recommends needed changes in the care received that may have led to better outcomes in that specific case. The MMRT releases an annual report of its findings. The most recent report can be found here.
Death Data
Definition: A pregnancy-associated death is defined as a death of a woman while pregnant or within one year of pregnancy regardless of the outcome of the pregnancy or the cause of death.
Data Source: Death (mortality) data are gathered from the Pregnancy-Associated Mortality Surveillance System at the Virginia Department of Health. Deaths are reported by the Virginia city or county where the decedent normally resided at the time of death, occurring in Virginia. Deaths to residents outside of Virginia are not included.
Manner of Death: The general category of the circumstances of the event which causes the death. The categories are accident, homicide, natural, suicide, and undetermined.
Causes of Death: The disease, injury, or poison that results in a physiological derangement or biochemical disturbance that is incompatible with life. The result of post-mortem examination, including autopsy and toxicological findings, combined with information about the medical history of the decedent, serves to establish the cause of death.
Manner and Cause of Death Definitions:
- Homicide: A manner of death indicating that the decedent was killed by another person.
- Suicide: A manner of death indicating that the decedent intentionally cause their own death.
- Motor vehicle accident (MVA): A death resulting from a motor vehicle accident.
- Hemorrhage: A death resulting from the loss of blood from a damaged blood vessel. It can be external (visible) or internal (hidden).
- Pulmonary embolism: A death resulting from a blockage in a lung artery, usually caused by a blood clot that has traveled from another part of the body.
- Amniotic fluid embolism (AFE): A death resulting from amniotic fluid enters the blood stream of the mother, triggering a serious reaction which results in cardiorespiratory collapse and massive bleeding.
- Infection: A death resulting from a viral, bacterial, or other infection EXCEPT for COVID-19 and HIV/AIDS.
- Pregnancy-induced hypertension (PIH): A death resulting from a condition that develops during pregnancy, characterized by high blood pressure without pre-existing hypertension.
- Cancer: A death resulting from a disease caused by an uncontrolled division of abnormal cells in a part of the body.
- Cardiac-Related: A death resulting from diseases and disorders that affect the heart and its circulatory system, except cardiomyopathy or pregnancy-induced hypertension.
- Exacerbation of chronic disease: A death resulting from the exacerbation of a chronic disease that was present prior to pregnancy.
- Ectopic pregnancy: A death resulting from a pregnancy in which the fetus develops outside the uterus, typically in a fallopian tube.
- Disorders of the central nervous system (CNS): A death resulting from neurological disorders that affect the structure or function of the brain or spinal cord.
- Accidental overdose (OD): A death resulting from the unintentional poisoning of a substance (legal or illegal) or medication (prescription and over-the-counter).
- Cardiomyopathy: A death resulting from a group of diseases that affect the heart muscle (myocardium). These diseases cause the heart muscle to become weakened, thickened, or scarred, making it difficult for the heart to pump blood effectively.
- AIDS: death occurring as a result of the most advanced stage of HIV infection, acquired immunodeficiency syndrome (AIDS), where the body's immune system is severely compromised
- COVID-19: A death resulting from COVID-19
- Other: Any other known cause of death that is not included in the list above.
- Undetermined: The cause of death could not be determined following a Medical Examiner investigation.
Ethnicity and Race: Only two ethnic classes are recognized in the data, Hispanic and Non-Hispanic, where the term Hispanic refers to persons who can trace their ancestry in some degree to the peoples of the Iberian Peninsula and the nations of Portugal and Spain. The term Latino is also used for Hispanic. Thus, a Hispanic person may be of any race. Presented race categories are based on the race methods and categories set forth by the U.S. Census Populations with Single Race Categories. The race is reported as race of the decedent at death.
Other: Data are produced and processed from sources believed to be reliable and accurate at that point of time. No warranty expressed or implied is made regarding accuracy, adequacy, completeness, legality, reliability or usefulness of any information. Additionally, not all data elements are reported at the source. Please see Virginia Code §32.1 for information on data mandated to be conveyed by the patient and/or facility. This disclaimer applies to both isolated and aggregate uses of the data. Unknown/Unreported variables were removed from the tables. Counts lower than 20 and their associated rates should be interpreted with caution.
Birth Data
Data Source: Birth (natality) data are gathered from the Vital Event Statistics Program at the Virginia Department of Health. Live births are reported by the Virginia city or county where the mother normally resided at the time of birth, regardless of where the birth occurred. Learn more about birth certificate data at the National Center for Health Statistics website.
Ethnicity and Race: Only two ethnic classes are recognized in the data, Hispanic and Non-Hispanic, where the term Hispanic refers to persons who can trace their ancestry in some degree to the peoples of the Iberian Peninsula and the nations of Portugal and Spain. The term Latino is also used for Hispanic. Thus, a Hispanic person may be of any race. Presented race categories are based on the race methods and categories set forth by the U.S. Census Populations with Single Race Categories. The race is reported as race of the decedent at death.
Other: Data are produced and processed from sources believed to be reliable and accurate at that point of time. No warranty expressed or implied is made regarding accuracy, adequacy, completeness, legality, reliability or usefulness of any information. Additionally, not all data elements are reported at the source. Please see Virginia Code §32.1 for information on data mandated to be conveyed by the patient and/or facility. This disclaimer applies to both isolated and aggregate uses of the data. Unknown/Unreported variables were removed from the tables. Counts lower than 20 and their associated rates should be interpreted with caution.
Maternal death
The death of a woman while pregnant or within 42 days of termination of pregnancy, regardless 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. This definition is used by the National Center for Health Statistics (NCHS) and the World Health Organization (WHO).
Pregnancy-associated death
A death during or within one year of pregnancy, regardless of the cause or the outcome of the pregnancy. These deaths make up the universe of maternal mortality; within that universe are pregnancy-related deaths and pregnancy-associated, but not related deaths.
Pregnancy-related death
A death during or within one year of pregnancy, from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy.
Pregnancy-associated, but not related death
A death during or within one year of pregnancy, from a cause that is not related to pregnancy.
Maternal Mortality
Maternal mortality refers to deaths while pregnant or within 42 days of termination of pregnancy. The MMRT program may use the term maternal mortality or pregnancy-associated mortality to encompass the topic of deaths during pregnancy, childbirth, and the postpartum period up to 365 days from the end of pregnancy.
Source: Eugene Declercq and Laurie Zephyrin, Maternal Mortality in the United States: A Primer (Commonwealth Fund, Dec. 2020).