Maternal Mortality Review Team

Maternal Mortality Review | Case Review Process | Reports | To Learn More

Scope of the Problem of Maternal Death

According to the World Health Organization, maternal mortality declined more than 40% worldwide between 1990 and 2014. However during the same time period, there was an approximately 26% increase in maternal mortality rates in the United States.

US Pregnancy-Related Mortality Rates





















*Rates exclude California and Texas

**Hoyert DL. Maternal mortality rates in the United States, 2020. NCHS Health E-States. 2022. 

In order to reduce the maternal mortality rate, the CDC recommends that state-level, systematic reviews of all maternal deaths be undertaken to identify prevention and intervention strategies. These review teams have identified risk factors associated with maternal death such as mental illness, substance abuse, obesity and chronic illness as well as confirmed the relationship between pregnancy and homicide.


Two sets of definitions are used to describe maternal deaths.

CDC/ACOG (American College of Obstetricians and Gynecologists) Definitions

Pregnancy-Associated Death – death of a woman while pregnant or within one year of termination of a pregnancy regardless of the cause of death or outcome of the pregnancy.

Pregnancy-Related Death – pregnancy-associated death resulting from one or more of the following:  1. complications of the pregnancy itself; 2. the chain of events initiated by the pregnancy that led to death; or 3. aggravation of an unrelated condition by physiological effects of the pregnancy that subsequently causes death.

These terms are used by individual states conducting maternal mortality review, including Virginia.

World Health Organization and National Center for Health Statistics (US Death Certificate) Definitions

Maternal Death – death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective 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.

Pregnancy-Related Death – death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death.

These terms are used by countries throughout the world so that trends can be identified and comparisons can be made.  They identify maternal deaths only through cause of death codes listed on death certificates.

Mission of the Virginia Maternal Mortality Review Team

Virginia’s Maternal Mortality Review Team is dedicated to the identification of all pregnancy-associated deaths in the Commonwealth and the development of interventions that reduce preventable deaths.

Virginia Maternal Mortality Review Team Member Organizations

Director, Office of Family Health Services, Co-Chair
Chief Medical Examiner, Co-Chair

American College of Nurse-Midwives, Virginia Chapter
American College of Obstetricians and Gynecologists, Virginia Section
Association of Women’s Health, Obstetrics and Neonatal Nurses, Virginia Chapter
Commonwealth’s Attorney
Community Services Board
Local Emergency Medical Services
Local Health Department, Virginia Department of Health
Local Fire Department
Local Law Enforcement
March of Dimes
Medical Society of Virginia
National Association of Social Workers, Virginia Chapter
Virginia Academy of Nutrition and Dietetics
Virginia Department of Behavioral Health and Developmental Services
Virginia Department of Health, Child and Family Health
Virginia Department of Health, Office of the Chief Medical Examiner
Virginia Department of Medical Assistance Services
Virginia Department of Social Services
Virginia Hospital and Healthcare Association
Virginia Midwives Alliance
Virginia Sexual and Domestic Violence Action Alliance

Funding Sources

Title V, Maternal and Child Health Block Grant

DP22-2211: Preventing Maternal Mortality: Supporting Maternal Mortality Review Committees

Program Contact

Melanie J. Rouse, PhD
(804) 205-3857