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Published on: July 19, 2019
Development and Implementation of a Statewide Maternal Autopsy Program in Alabama
Paul V Benson1, Daniel Atherton, Lindsay Harris
1Division of Anatomic Pathology, Department of Pathology, and the Department of Obstetrics and Gynecology, Heersink School of Medicine, University of Alabama at Birmingham, and the Department of Health Policy and Organization, University of Alabama at Birmingham School of Public Health, Birmingham, the Alabama Department of Public Health, Montgomery, and the Department of Obstetrics and Gynecology, University of South Alabama, Mobile, Alabama.
Alabama established a statewide autopsy program to improve the accuracy of determining causes of maternal deaths. This initiative addresses challenges faced by Maternal Mortality Review Committees (MMRCs) in understanding complex cases and reducing high maternal mortality rates.
Area of Science:
- Public Health
- Forensic Pathology
- Maternal Health
Background:
- Alabama's 2022 maternal mortality rate was 38.6 per 100,000 live births, ranking third highest nationally.
- Maternal Mortality Review Committees (MMRCs) face challenges in determining causes of death due to complexity and unclear circumstances.
- Low autopsy rates (41.9%) and undetermined pregnancy relatedness (19.4%) hindered Alabama's MMRC's ability to make actionable recommendations.
Purpose of the Study:
- To outline the process of developing and implementing a statewide autopsy program for maternal deaths in Alabama.
- To improve diagnostic accuracy for maternal deaths through standardized autopsy procedures.
- To increase access to autopsy services for deaths occurring during pregnancy or up to 365 days postpartum.
Main Methods:
- Formal recommendations by the Alabama MMRC to increase autopsy access.
- State and community partner advocacy for funding a statewide autopsy program.
- Establishment of the Alabama Maternal Autopsy Program in 2023.
Main Results:
- The Alabama Maternal Autopsy Program ensures access to autopsy services for all pregnancy-associated deaths.
- Standardization and improved access to autopsy are expected to enhance diagnostic accuracy.
- The program aims to provide clearer cause-of-death determinations for complex maternal mortality cases.
Conclusions:
- Implementing a statewide maternal autopsy program is crucial for improving understanding of maternal mortality.
- Enhanced diagnostic accuracy through autopsies supports the development of effective prevention strategies.
- This initiative represents a significant step toward reducing Alabama's maternal mortality rate.
