Maternal Mortality Review Information Application - MMRIA
Although maternal mortality review committees (MMRCs) have been in place for some time, there has never been a standardized data system available to support essential review functions. MMRIA, or "Maria," reflects lessons learned from implementing a previous version of the system, the Maternal Mortality Review Data System (MMRDS), among 13 state MMRCs.
MMRIA is designed to support and standardize:
- Data abstraction
- Case narrative development
- Documentation of committee decisions
- Routine analysis
MMRIA is free and publicly available. However, states and jurisdictions interested in using MMRIA are encouraged to work in close partnership with the MMRIA team at CDC. The MMRIA team provides programmatic assistance to help committees use the system effectively and reduce duplicative processes during abstraction, case review, and analysis. After getting in touch, access the materials below.
- Visit www.mmria.org and follow the download and installation instructions.
- MMRIA is regularly updated with system and feature improvements. Follow the instructions on www.mmria.org for downloading and installing new versions, while preserving your existing data. Work in close partnership with the MMRIA team in completing these steps.
MMRIA is much more than a data system – it supports developing a common language for reviews to work together. It supports the breadth of scope and processes of MMRCs, recognizing that no two MMRCs are the same, but all can work toward a shared vision. Therefore the MMRIA project includes numerous resources for each step of a standard approach to case review. To see all MMRIA materials, visit the Review to Action Resource Center. Below are some key highlights:
- Abstractor Manual: This manual is an in-depth guide to case abstraction, intended for abstractors both seasoned and new to their positions.
- MMRC Facilitation Guide: This guide is intended to help maternal mortality review committees establish processes for case review. The guide is structured in the order of the steps a committee might take in conducting an actual review committee meeting.
- Committee Decisions Form: This form is a recommended format for documenting key decisions and recommendations made by the MMRC. It maps back to the fields in MMRIA for ease-of-entry during or after committee meetings.
- Case Identification Process: This diagram describes the process used for case identification, abstraction, review and data system entry.
What is this report?
A preliminary report of data from four states using an innovative data-collection system provides the first in-depth look at key factors contributing to maternal death and showcases opportunities for prevention.
- It offers concrete evidence that a maternal death is the tragic result of an intersection of a number of factors. It is the sum of a range of circumstances related to communities, healthcare facilities, providers, and patients. On average, three to four critical factors were identified for each pregnancy-related death.
- This report highlights that causes of pregnancy-related death differ by age and depending on whether a woman was pregnant, was in delivery or had recently delivered.
- These data also show that mental health conditions were a leading cause of pregnancy-related death in these four states. More specifically, among postpartum women, suicide most commonly occurs in the late-postpartum period.
- As more states participate, we can use these data to identify causes and contributing factors to pregnancy-related death and the prevention opportunities with the greatest potential impacts.
- MMRIA is a powerful resource, allowing states to collaborate around a shared data framework and initiate discussions around how the data can inform improvement activities. The United States can best save lives and prevent harm by thoughtful and strategic practices that honor states’ unique contexts and needs, and at the same time adopt a cohesive approach that leverages all of the data we collect on maternal deaths. In February 2017, project staff released the first ever report combining data from multiple MMRCs as a proof of concept, a recognition of our common commitment to reducing preventable maternal deaths, and a reminder that we can only fulfill our commitment by working together. The first report includes data from four states: Colorado, Delaware, Georgia, and Ohio. The following year, the MMRIA project staff will release a more comprehensive report that engages more states in this shared endeavor.
MMRIA Events and Activity Updates
Last Updated: June 26, 2017
- June 24, 2017: At the AWHONN Annual Convention in New Orleans, LA, a representative of the Delaware review committee will present MMRIA in the context of the TERCAP mortality interview tool.
- September 2017: During the Annual Meetings for ACOG Districts V, VIII, and IX in Anaheim, CA (September 8, 2017), and ACOG Districts VI, VII, and XI in San Antonio, TX (September 15), the MMRIA team will present standard maternal mortality review tools developed by the initiative. To view the resources and tools, visit the Resource Center.
- September 20, 2017: At the CityMatCH MCH Leadership Conference & Healthy Start Convention in Nashville, TN, the MMRIA team will present lessons learned from using combined data from multiple maternal mortality review committees, and highlight opportunities to strengthen their impacts, particularly focusing on collaboration opportunities at the community- and city-level.
Where has the MMRIA team been lately?
Since the winter of 2016, the team has provided 1:1 on-site support to the following jurisdictions:
- New Jersey
- New Mexico
- New York City
- North Carolina
- South Carolina
- U.S.-Mexico Border Health Commission