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Alabama is confronting its alarming maternal mortality crisis with a groundbreaking statewide Maternal Autopsy Program, a bold initiative to better understand and prevent maternal deaths. The Alabama Department of Public Health (ADPH) first launched the program in December 2023, providing free autopsies for women who die during pregnancy or within a year postpartum. Initially introduced in eight counties, the program expanded statewide in May 2024 to ensure that all families have equitable access to this critical service.
Alabama’s maternal mortality rate, 64.63 deaths per 100,000 live births, is nearly double the national average of 34.09. Black women in Alabama bear a disproportionate burden, with their pregnancy-related mortality rate almost double that of White women. The Maternal Mortality Review Committee (MMRC), which reviews deaths to determine causes, contributing factors, and preventability, found that nearly half of maternal deaths in 2018-2019 lacked autopsies—leaving significant gaps in understanding the root causes.
The Maternal Autopsy Program addresses these gaps by providing comprehensive autopsies conducted at the University of Alabama at Birmingham (UAB) and the University of South Alabama (USA). The initiative also removes financial and logistical barriers for grieving families by covering the costs and transportation, facilitated by Mack Mortuary Transport Services. Each case is reviewed in collaboration with the MMRC to uncover critical insights into maternal deaths and develop targeted interventions.
Findings from the MMRC’s reviews have underscored the program’s necessity. Of the 93 maternal deaths reviewed from 2018-2019, 24 were pregnancy-related. Infections, cardiovascular conditions, and hemorrhage were identified as the leading causes, and 15 of these deaths were deemed preventable. The data highlight the urgency of addressing gaps in healthcare access and the need for timely recognition and treatment of symptoms to prevent these tragedies.
Nationally, the maternal mortality rate has been a growing concern, with the U.S. reporting 32.9 deaths per 100,000 live births in 2021, up from 20.1 in 2019. Black women face mortality rates 2.6 times higher than White women, reflecting systemic inequities in healthcare access and outcomes. While recent data indicates a decline in maternal deaths to pre-pandemic levels in 2023, disparities persist, and challenges such as rural hospital closures and restrictive abortion laws threaten further progress.
The Maternal Autopsy Program is a vital tool in Alabama’s fight to reduce maternal mortality and address systemic disparities in healthcare. By uncovering the underlying causes of maternal deaths, the program aims to inform policy changes, improve healthcare practices, and save lives. Through this initiative, Alabama is taking a significant step forward in addressing its maternal health crisis, offering hope for a future where maternal deaths become a rare occurrence rather than a persistent tragedy.
