The Alliance for Innovation on Maternal Health (AIM) program seeks to reduce preventable maternal mortality and severe maternal morbidity (SMM) within the Unites States (US). Through developing national partnerships and resources, AIM assists state-based teams in implementing perinatal quality improvement (QI) tools to achieve the program goals. The mission of AIM is to support best practices that make birth safer, improve maternal health outcomes, and save lives.

The AIM Program was founded and is fully funded by the Health Resources and Services Administration's (HRSA) Maternal Child Health Bureau (MCHB) through a cooperative agreement awarded to the American College of Obstetricians and Gynecologists (ACOG). This agreement was awarded in 2014 originally and a second cycle of funding was awarded in 2018. Throughout the nine years since its inception, AIM has enrolled state-based QI teams and provided technical assistance (TA) and capacity-building resources to support implementation of PSBs.

Despite rapid expansion and successes of AIM and other national and regional maternal health QI endeavors, pregnancy-related mortality remains high in the United States with persistent racial, ethnic, and geographic disparities [1]. Further review of data from Maternal Mortality Review Committees in 36 states show that causes of pregnancy-related deaths vary by race and ethnicity [2], and reviews of pregnancy-related deaths from 9 states show that causes also vary by timing during pregnancy and in the 12 months postpartum [3].

In addition to the high rates of maternal mortality in the United States, around 30,000 people are known to have experienced SMM in 2020 [4]. SMM is defined by the Centers for Disease Control and Prevention as “unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to [an individual's] health” [5]. SMM includes adverse outcomes such as eclampsia and sepsis and is calculated using ICD-10 codes. While the SMM definition examines adverse outcomes during the delivery hospitalization only, it should be noted that morbidity can occur at any point during pregnancy or the 12 months postpartum. Like maternal mortality, racial and ethnic disparities in rates of SMM persist [4].

AIM implementing entities, which encompass regional state- and jurisdiction-based QI teams, often in the form of perinatal quality collaboratives (PQCs), as well as individual hospital and health system birthing facilities, continue to engage with and seek technical assistance (TA) and support from the AIM National Team. As AIM has grown, the number and types of resources provided have also evolved to reflect the needs of these entities, including a variety of direct learning opportunities, data collection and analysis support, and enduring multimodal reference materials. This paper reviews key program areas and highlights, describing their evolution to be responsive to AIM implementation entity needs, as well as program reach, impact, and future opportunities to address barriers to and strategies to promote PSB implementation.