Recognizing and managing complications to prevent maternal deaths.

THE goal of all labor and delivery units and of birthing centers is a safe birth for both newborn and mother. Yet, an examination of current statistics raises significant questions about whether that aim is being achieved. A report released this year found that more than 2 women die of pregnancy-related causes every day in the United States, with the maternal mortality ratio doubling from 6.6 deaths per 100 000 births in 1987 to 13.3 deaths per 100 000 births in 2006.1 This means that the likelihood of a woman dying in childbirth in the United States is 5 times as great as in Greece, 4 times as great as in Germany, and 3 times as great as in Spain.1 Maternal mortality rates in the state of California alone have nearly tripled from 1996 to 2006,2 rising to nearly 17 deaths per 100 000 live births in 2009. As serious as these statistics are, the study warns that the number of maternal deaths in the United States may actually be much higher because of a lack of federal reporting requirements and incomplete data collection at state and local levels.