Strategies to reduce maternal mortality in developed countries

To review the recent literature regarding maternal mortality, especially in developed countries, and to provide suggestions for clinical action addressing the rising trend. Worldwide maternal deaths declined over the past 20 years; however, it is unlikely that the United Nations' Millennium Development Goal 5 for a 75% reduction in maternal mortality by 2015 will be achieved. Ninety-nine percent of the annual preventable maternal deaths from complications of pregnancy and childbirth occur in developing countries, particularly sub-Saharan Africa. In developed countries, including the United States, numerous strategies have developed to recognize the factors leading to maternal death and to implement systems' changes allowing interventions. In many cases, maternal death is avoidable but oftentimes a patient is saddled with life-long medical consequences. Near-misses are increasing which place a burden not only on the family but also on the healthcare system and overall community. The United States has a rising trend in maternal deaths. To achieve a reduction within all developed countries there must be coordinated death review activities that investigate every case along with near-misses. Recommendations for changes within the medical system will continue to improve maternal health not only in developed countries but also worldwide.