California Pregnancy-Associated Mortality Review (CA-PAMR)
The death of a pregnant or recently pregnant person is a rare but tragic event for the families and communities left behind, and society as a whole. In California, around 70 pregnant and birthing people die annually from pregnancy or childbirth complications. Sadly, many of these deaths are preventable.
The Centers for Disease Control and Prevention defines a
pregnancy-related death as “the death of a woman during pregnancy or within one year of the end of pregnancy from a
pregnancy complication , a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy.”
In 2006, the California Department of Public Health’s Maternal, Child and Adolescent Health Division (MCAH) established the California Pregnancy-Associated Mortality Review (CA-PAMR) to comprehensively review deaths among pregnant or recently pregnant Californians, up to one year after pregnancy. Each death is examined through a health equity lens and considerations include how social determinants of health, discrimination and racism may have contributed to the death. Through detailed case reviews, CA-PAMR’s multidisciplinary committees of clinical and community experts
- determine the underlying causes of pregnancy-related deaths;
- identify contributing factors at the individual/family, provider, facility, system and community levels;
- discuss quality improvement and preventive strategies at the individual/family, provider, facility, system and community levels and preventability; and
- make actionable data-informed recommendations for preventing pregnancy-related deaths and optimizing maternal health outcomes and experiences equitably for all pregnant and birthing people.
The ultimate goal of CA-PAMR is to eliminate preventable pregnancy-related deaths and associated health inequities. (For information on how these deaths are identified and tracked, visit CA-PMSS.)
CA-PAMR is a collaboration between MCAH, its contracting partners at Stanford University's California Maternal Quality Care Collaborative (CMQCC) and the Public Health Institute (PHI), and its multidisciplinary expert committees.
This focused-topic review is examining deaths due to obstetric hemorrhage in 2014-2018.
This focused-topic review is examining Covid-19 deaths suspected to be related to pregnancy in 2020-2022.
This is a regional, population-based review of all deaths suspected to be medically related to pregnancy that occurred in Los Angeles, Orange, Riverside and San Bernardino counties beginning in 2019. This region was defined based on the annual number of pregnancy-related deaths, sociodemographic diversity, systems of care, and geographic proximity of the counties.