Sarcouncil Journal of Multidisciplinary

Abstract: Despite significant investments in health-care delivery systems and the use of advanced health-care technologies, maternal mortality and morbidity remain major public health problems in the United States. By contrast, many high-income countries have had sustained and substantial decreases in maternal death rates, while in the United States, maternal death rates have been alarmingly high and increasing, suggesting systemic problems in the health care system. This review collates recent research to explore clinical, socioeconomic and systemic risk factors associated with maternal death and serious adverse outcomes. It concludes that both chronic health conditions and social inequalities and barriers to care are intricately involved in shaping outcomes. The policy environment sets the context for the delivery and prioritisation of care. Chronic conditions like cardiovascular disease, hypertensive disorders of pregnancy, and obesity remain major drivers of maternal mortality, and racial and ethnic inequities continue to reflect systemic inequities deeply rooted in health care systems. The risks faced by the mother are compounded by socioeconomic disadvantage, inequities in the quality of care, and inadequate access to basic health services. Moreover, behavioral and psychosocial issues such as mental health problems are increasingly acknowledged as significant factors contributing to maternal morbidity, supporting the need for a holistic approach. This review emphasizes the need for multi-level interventions to address clinical care and broader structural inequities to save preventable lives and work toward health equity in the United States.