From Review to Reform: Strengthening Maternal Mortality Committees

From Review to Reform: Strengthening Maternal Mortality Committees

May 30, 2025

By Brittany M. Woodman, Esq.

The Society for Maternal-Fetal Medicine (“SMFM”) has issued a compelling new statement advocating for strengthened and standardized Maternal Mortality Review Committees (“MMRCs”) in every U.S. state. [1]. As maternal mortality rates continue to rise, reaching 33.2 deaths per 100,000 live births in 2021, the need for structured, data-informed oversight has become a matter of public health concern. Id. The new statement lays out eleven core policy recommendations aimed at reducing preventable maternal deaths and addressing long-standing racial and structural inequities in maternal health outcomes. Id. 

MMRCs are multidisciplinary committees that meet at state and local levels to review deaths occurring during pregnancy and up to one-year postpartum. [2]. These committees analyze medical, social service, and vital records to uncover contributing factors and propose targeted prevention strategies. [1]. The Centers for Disease Control and Prevention (“CDC”) has found that over 80% of pregnancy-related deaths are preventable, and that 47% occur between 7 and 365 days postpartum, well beyond the traditional 42-day window used in the World Health Organization’s definition of maternal death. [1], [3].  

Emphasizing the importance of timelines, SMFM recommends that MMRCs review all deaths during pregnancy and up to one-year postpartum, including those related to mental health conditions, substance use, suicide, and intimate partner violence. [1]. These cases are often misclassified as incidental but may, in fact, be directly related to pregnancy. Id.  

SMFM additionally calls for MMRCs to have complete authority to access all relevant records and to operate within a structured timeframe: identification of cases within one year of death, review within two years, and public reporting within three years. Id. The statement explains these reports should be issued in a standardized format, using the CDC’s Maternal Mortality Review Information Application (“MMRIA”), which enables consistency across states and facilitates national-level analysis. [1], [5].  

To ensure equitable outcomes, SMFM urges MMRC reports disaggregate data by race, ethnicity, insurance type, and geographic location. [1]. This aligns with CDC findings from 2020, which revealed concerning disparities amongst groups in the underlying causes of pregnancy-related deaths. [3]. For example, cardiovascular conditions were the leading cause of death among non-Hispanic Black women, while mental health conditions were most common among non-Hispanic White women. Id.  

The SMFM position statement also highlights the value of nonclinical voices. It recommends that MMRCs include community members and conduct interviews with families and close contacts of the deceased to gather contextual insights that medical records alone cannot provide. [1]. This patient-centered approach enhances the committee’s ability to craft practical and compassionate recommendations. 

Recognizing MMRCs cannot operate without consistent support, SMFM calls for stable state and federal funding. [1]. Many committees currently rely on the CDC’s Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (“ERASE MM”) initiative, which supports 46 states and several U.S. territories. [5]. However, state-level budget commitments are essential to ensure continuity and independence.  

To turn data into action, SMFM has launched the Data to Action Training and Activation (“DATA”) Academy, a CDC-funded program designed to equip physicians with the tools to implement MMRC findings at the institutional, legislative, and community levels. [6], [7]. The DATA Academy helps bridge the gap between MMRC reviews and real-world policy change by offering training on stakeholder engagement, action plan development, and health equity-centered communication. [6].  

SMFM’s latest position statement is both a roadmap and a call to action. As maternal mortality continues to disproportionately impact communities of color and underserved populations, clinical interventions alone are not enough. MMRCs offer a data-driven, interdisciplinary approach to prevention, but only if they are empowered with the authority, funding, and framework necessary to drive meaningful change. 

Citations: 
[1] Society for Maternal-Fetal Medicine, E. Nicole Teal, Cresta W. Jones, Olaide Ashimi Balogun & Lindsay Speros Robbins, “Society for Maternal-Fetal Medicine (SMFM), Position Statement: Maternal Mortality Review Committees,” Pregnancy (May 2025), https://doi.org/10.1002/pmf2.70019 (unless otherwise specified, all articles were last accessed on May 16, 2025).  
[2] Center for Disease Control & Prevention, “About Maternal Mortality Review Committees,” CDC (May 15, 2024), https://www.cdc.gov/maternal-mortality/php/mmrc/index.html. 
[3] Center for Disease Control & Prevention (CDC), “Pregnancy-Related Deaths: Data From Maternal Mortality Review Committees in 38 U.S. States, 2020,” Maternal Mortality Prevention (May 28, 2024), https://www.cdc.gov/maternal-mortality/php/data-research/index.html. 
[4] Center for Disease Control & Prevention, “Maternal Mortality Review Committee Decisions Form,” Maternal Mortality Prevention (May 23, 2024), https://www.cdc.gov/maternal-mortality/php/mmrc/decisions-form.html.  

[5] Center for Disease Control & Prevention, “Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM),” Maternal Mortality Prevention (Aug. 07, 2024), https://www.cdc.gov/maternal-mortality/php/erase-mm/index.html.  

[6] Society for Maternal-Fetal Medicine, “Data to Action Training and Activation (DATA) Academy,” Data Academy (2024), https://www.smfm.org/data-academy. 

[7] Society for Maternal-Fetal Medicine, “SMFM Announces Cooperative Agreement with CDC,” News (Oct. 3, 2024), https://www.smfm.org/news/smfm-announces-cooperative-agreement-with-cdc. 

Disclaimer: This publication is not intended to provide legal advice but to provide general information on legal matters. Transmission is not intended to create and receipt does not establish an attorney-client relationship. Readers should seek specific legal and/or medical advice before taking any action with respect to matters mentioned in this publication. The attorney responsible for this publication is Brittany Woodman. This post constitutes a form of attorney advertising as defined by some state bar associations.