Maternal Mortality Review Committees

Overview

Maternal mortality rates in the United States are tragically high, and the vast majority of maternal deaths—roughly 80%—are preventable. With maternity care deserts growing and access to ob-gyn care decreasing across the United States, being proactive in preventing maternal deaths is more critical than ever. Maternal mortality review committees, or MMRCs, are an indispensable tool for understanding maternal mortality and ultimately saving patients’ lives.

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What Are MMRCs?

MMRCs are multidisciplinary state- or local-level groups that provide comprehensive review of deaths that happen during pregnancy or within one year postpartum and represent input from those with clinical and nonclinical expertise. Committee members review and analyze data on pregnancy-related deaths and examine individual cases of maternal deaths to inform and develop recommendations to decrease and prevent pregnancy-related deaths.

Why Are MMRCs Important?

MMRCs can do a deeper dive into pregnancy-related deaths by reviewing data from a variety of sources, such as autopsy records and informant interviews, and identifying clinical and nonclinical factors that contributed to each death to create a more complete picture of how these deaths occur. By understanding pregnancy-related deaths, MMRCs can create more comprehensive recommendations and strategies for preventing them.

What Affects MMRC Review?

Several factors affect MMRCs’ ability to collect and analyze data and recommend interventions to reduce pregnancy-related deaths and save lives:

• Funding. MMRCs need consistent state and federal funding to support an uninterrupted review process and access to necessary resources.
• Data reporting. The more data available to MMRCs, the more thorough their review, analysis, and recommendations can be. MMRCs must consider all relevant data available without bias or omissions to ensure a complete and accurate case review and publish quantitative and qualitative data for their state. State data also helps inform maternal mortality trends at the national level.
• Committee members. It is critical that MMRCs be nonpartisan, independent groups to reduce the risk of bias and nonscientific ideological viewpoints in reporting and recommendations. MMRCs must be able to work autonomously, without outside influence from politicians or other entities affecting member selection or committee recommendations. Members must be free of bias and conduct their work free of personal preconceptions.
• Patient privacy. MMRCs review cases through an anonymous and confidential process in which the identities of patients, health care professionals, and facilities are not disclosed. The anonymity of the patients whose cases are being reviewed and the data gathered must both remain confidential. 
• Threat of punishment. MMRCs are nonpunitive bodies. MMRC findings cannot be used to pursue civil or legal action against physicians or institutions, and committee members, witnesses, and other parties providing information are protected from personal liability regarding activities during the review process. Immunity allows MMRC members, witnesses, physicians, and institutions to participate fully in the review process.

Recommendations

• Congress must swiftly pass the Preventing Maternal Deaths Reauthorization Act. Congress recognized the need to act on rising maternal mortality rates when it enacted the bipartisan Preventing Maternal Deaths Act in 2018. Since that time, and thanks to the program that act authorized, the number of states with MMRCs has increased from 32 to nearly 50. Authorization for that program expired on September 30, 2023. ACOG urges Congress to pass the Preventing Maternal Deaths Reauthorization Act to ensure MMRCs can continue their important work.
• All members of MMRCs should be unbiased, free of conflicts of interest, and focused on the patients themselves when evaluating maternal mortality.
• All deaths that occur during pregnancy and up to one year after in each state should be reviewed, regardless of cause.
• States should participate in the Maternal Mortality Review Information Application, CDC’s federal maternal mortality data tracking system.