Maternal mortality review committees (MMRCs) can play a critical role in counting and documenting maternal deaths, understanding why they occurred, and supporting evidence-based solutions to the US maternal health crisis. Sadly, instead of supporting this important work, some states are trying to push their committees, outspoken members, and the critical data they review into the shadows. Unsurprisingly, the same states that are hostile toward abortion are now directing that hostility toward the professionals who review and make recommendations about pregnancy-associated deaths. The threat of those states weaponizing review committees looms large as battles for reproductive health data privacy unfold in state houses across the country.
Every state has an MMRC, though the scope of their work varies significantly. All of the state committees review pregnancy-related deaths, and most make recommendations for prevention. Still, many do not track maternal morbidity data, review those trends, or determine preventability, leaving unanswered questions about causes and prevention.
The Commissioner of Georgia’s Department of Public Health, Dr. Kathleen Toomey, took drastic action last year when she disbanded the state’s MMRC in response to the publicization of two women’s abortion-related deaths. Amber Nicole Thurman and Candi Miller were among the first women to die of pregnancy-related causes in Georgia under the state’s strict six-week abortion ban. The committee determined that both of their deaths could have been prevented by legally accessible abortion care. Doctors waited 20 hours to operate on Amber Thurman in a legal landscape where providing abortion care is now a felony. Candi Miller’s family said she hadn’t seen a doctor due to the ban. Georgia has one of the nation’s highest maternal mortality rates, and the abrupt dismissal of the committee is likely to cause delays in reviewing important cases.
Idaho, which continues to enforce its legally disputed near-total abortion ban, allowed its MMRC to expire in 2023. State legislators restored the committee in 2024 but didn’t even begin to fill positions until November, delaying the review process by over a year.
Texas’s MMRC announced a decision not to review pregnancy-related death cases from the years immediately following the 2022 implementation of its near-total abortion ban and to delay a report scheduled for release during an election year. When one member, Nakeenya Wilson, spoke out and expressed her concern with this decision, the legislature swiftly recomposed the committee to push her out, replacing her with an anti-abortion member. Lawmakers also allocated funds to account for the withdrawal of Texas from a federal maternal death tracking system, despite warnings from committee members against such action. Until recently, some committee members were not even aware that the 2013 statute establishing the committee specifically prohibits its reviewing of abortion-related deaths.
The Centers for Disease Control and Prevention’s (CDC) standardized case review process has been adopted by 41 states, but only 10 states consider racial disparities in their reviews, and only 6 states require committee reports to address racial inequities. This is despite the fact that, nationwide, Black women are about three times more likely to die from pregnancy-related causes. Maternal morbidity, which includes any pregnancy-related health condition that has negative outcomes for a birthing patient’s well-being, is reviewed by only 12 states and tracked by only 6 states, further detracting from our understanding of the true magnitude of the broader maternal health crisis.
When states restrict transparency around maternal mortality, they obscure important data trends, root causes, and prevention strategies. Worse, those states also keep families in the dark about the deaths of their loved ones. The Georgia committee that reviewed the deaths of Amber Nicole Thurman and Candi Miller unearthed more information about the causes of their deaths than coroners initially reported. These women deserved futures, and their families deserve to know how those futures were denied by delayed abortion care.
States that seek to silence experts, conceal tragic truths, and flee accountability aren’t convincing anyone that maternal mortality is any less of an emergency. Instead, their negligence only sounds alarms about their complicit role in risking the lives and well-being of pregnant women in their communities.
We cannot prevent what we do not measure. This session, state lawmakers must take inventory of their MMRCs and look to fill gaps in the demographic data, related causes, and preventable deaths they review and report on. They can also diversify the expertise and identities of committee members and expand the scope of pregnancy-associated conditions they investigate. These findings are critical to informing and developing best practices in perinatal and postpartum care and ultimately securing better health outcomes for mothers.
Above all, states can promote the transparency of these democratically established, public-serving committees and deliver well-deserved answers about tragic maternal deaths and how to prevent them. The best way to honor the lives lost to preventable pregnancy-related deaths is to tell their stories and empower mothers to write the stories of their own futures by securing access to lifesaving abortion care and providing high-quality, evidence-based maternal health care for women and families.
To learn about IWPR’s federal policy recommendations on maternal health care, click here.
