Role of title v MCH programs in state maternal mortality reviews: Moving recommendations to action

More than two women a day die in the U.S. due to pregnancy-related causes. Maternal mortality review (MMR) committees are necessary for ensuring all pregnancy-related deaths are identified and reviewed, and effective prevention actions are developed.

Throughout 2011 and 2012, the Association of Maternal and Child Health Programs and the Centers for Disease Control and Prevention partnered on an assessment of maternal death review programs. Twenty state and 2 local MMRs were selected, based on best evidence they were currently active, to participate in an online assessment of MMR processes. The questionnaire assessed funding and staffing; case identification; data abstraction and review; legislation; challenges; and examples of translation. Direct key informant interviews with MMR program leadership informed the development of case studies highlighting successful translation of MMR recommendations into effective prevention actions.

The majority of MMRs depend on funding (85% among funded MMRs), and administrative and analytic support (75%), from Title V MCH Block Grant Programs. The most commonly identified challenges to conducting MMRs were: funding; accessing records; and lack of legal protection, standard guidelines for review processes, data systems, and mechanisms for networking with other reviews. Examples of translating recommendations into action include postpartum depression assessment legislation; implementing universal prenatal behavioral health screening; establishing maternal autopsy standards; and developing hypertension guidelines for pregnant women.

The MMR process plays an essential role in identifying opportunities for reducing pregnancy-related mortality and morbidity. Despite multiple challenges, MMRs in the U.S. continue to operate effectively, with Title V Programs in a central role.