About the IMPROVE Initiative

An estimated 700 U.S. women die each year from conditions related to or associated with pregnancy or childbirth, the highest maternal mortality rate among developed nations. In addition, more than 50,000 women experience severe maternal morbidity (SMM), life-threatening health problems that are present during labor and delivery that can cause significant short- and long-term health problems for mothers.

The NIH-wide IMPROVE initiative supports research on how to reduce preventable maternal mortality, decrease SMM, and promote health equity. Using an integrated approach to understand biological, behavioral, sociocultural, and structural factors contributing to maternal mortality, SMM, and maternal morbidity, including a focus on the ongoing COVID-19 pandemic, the IMPROVE initiative will build an evidence base for improved care and outcomes in specific populations and regions of the country.

This multipronged, innovative research initiative is designed to understand and reduce health disparities among populations disproportionately affected by maternal morbidity and mortality, including African American, American Indian/Alaska Native, Asian/Pacific Islander, Hispanic/Latina, very young women, older women, and women with disabilities. Many of these populations are also disproportionately affected by the COVID-19 pandemic. The IMPROVE approach also addresses geographic disparities and social determinants of health, including education, racism, and socioeconomic standing.

Initiative Goals

The IMPROVE initiative aims to:

  • Address the foremost causes of maternal mortality in the United States, which include cardiovascular disease, infection, embolism, and immunity—as well as significant pregnancy-associated and pregnancy-related health complications, such as diabetes, obesity, mental health disorders, and substance use disorders.
  • Identify biological, behavioral, sociocultural, and structural factors that contribute to disparities in maternal health and delays or disruptions in maternal care.
  • Investigate the potential effects of emerging infections, such as SARS-CoV-2, on pregnancy-related deaths and complications in different geographic regions and communities.
  • Support the development of technologies, tools, devices, and interventions that predict or diagnose risk for maternal morbidity and mortality, reduce preventable causes of maternal deaths and improve health with a focus on mitigating maternal health disparities.
  • Help create tailored, evidence-based maternal health-related solutions for women across the country to promote maternal health equity
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