Severe maternal morbidity – we need more action to prevent harm

Abstract

Reviewing severe maternal morbidity (SMM) is considered a marker of the quality of maternity care, as in high income countries (HIC) maternal mortality is thankfully now rare. 1 SMM disrupts maternal (and wider family) wellbeing, causing considerable personal and public cost. SMM preventability review has the potential to reduce this and the associated harm. To do this, we must identify its occurrence, review these cases, and analyse findings to develop appropriate system improvements.As Joanne Frost and her colleagues in this current Australian and New Zealand Journal of Obstetrics and Gynaecology state, there is currently no national consensus or agreement in Australia on terms to use, definitions to follow and therefore no ability to compare inter-state data on the rates and causes of SMM. There is also no defined process to assess preventability in Australia and without this at the outset it is difficult to see how change would be effected. While in Aotearoa (New Zealand), our Health Research Council has previously funded research to enable national SMM preventability reviews, across both countries there appears to be no will by our respective governments to provide ongoing funding to enable routine SMM preventability reviews to take place. 2 No funding is currently available at regional, state, or national levels, and there is no apparent plan for these reviews to become 'business as usual'. This is regrettable, as opportunities are being missed to improve poor maternal and baby outcomes.