Materials and Methods
Mortality review provides a theory and method for iden-
tifying and understanding risk factors within a population.
Grounded in public health and focused on prevention, these
reviews involve in-depth examination of the circumstances
surrounding death. Mortality reviews function to improve
understanding of all factors influencing the problem so that
recommendations and interventions can be developed to
reduce death. The method of mortality review involves
collecting and examining records generated through the
investigation of a fatal illness or injury, and in this case,
pregnancy-related death.
Both committees in Virginia and Florida follow the
Centers for Disease Control and Prevention’s (CDC) rec-
ommendations set forth in Strategies to Reduce Pregnancy
Related Deaths [
8
]. Vital Records Offices in both states
identify cases of pregnancy-associated death (deaths
occurring in a woman who was pregnant at the time of
death or had a pregnancy in the year prior to death) in three
categories: (1) examining the death certificate check box
related to pregnancy status; (2) reviewing death certificate
cause of death indicating death was directly attributable to
pregnancy; and (3) matching death certificates of women of
reproductive age with birth and fetal death certificates to
identify deaths occurring among women who delivered in
the year preceding death. Florida also links death certifi-
cates to a state mandated prenatal risk screen of all preg-
nant women through Florida Healthy Start. The overall
percentage of women screened ranged from 81 to 86 % in
2009 and 2011 respectively.