- Through the International Classification of Diseases (ICD), Tenth Revision, specifically those deaths identified with a cause code in the “pregnancy, childbirth and the puerperium” categories.
- By matching birth or fetal death certificate with maternal death certificate information, regardless of cause of death.
- By selecting cases where a Commonwealth of Virginia death certificate indicates the decedent was pregnant within three months of the death. This is a check box on Virginia’s death certificate.
- Vital statistics (death certificates, birth certificates, fetal death records)
- Prenatal records
- Hospital records (outpatient and inpatient stays)
- Other provider/specialist records: these records may be from preconception/family planning clinics, or primary care providers, etc
- Autopsy reports and case findings from hospital, coroner, or other medical examiner
- Police/investigative reports
- Social services reports
- Mental health records
- Substance abuse treatment records
- Medical transport records
- Court records
- News articles, where relevant
The Team reviews de-identified case summaries. Team discussion and deliberation are governed by these values:
- Multidisciplinary review
- A public health approach
- Retrospective review
- Consensus decision-making
The Team collaboratively completes a Contributors to Mortality form. This discussion includes the Team’s decision about the following primary dimensions of maternal deaths:
- the underlying cause of death;
- the preventability of the maternal death, which is broadly defined as a death that may have been averted by one or more changes in clinical care, facility infrastructure, community and/or systems response to patient factors;
- the degree to which the death was pregnancy related;
- factors that potentially contributed to the death;
- recommendations for prevention and intervention.