Information in this section includes excerpts from the comprehensive Abstractor Manual developed by the MMRIA project, a partnership with Review to Action. For more detailed information, please download the manual from the recommended resources below.
Case review is the stage where the value of a maternal mortality review committee (MMRC) is fully demonstrated.
The MMRC should follow a clear and structured process for case review. Using a standard process has many benefits:
While the process selected may vary by state, the following reflects a guide to best practices for each case review meeting:
During the case presentation process, cases should be presented by a designated person such as the committee coordinator or chairperson. The committee may also choose to have the case abstractor report details about the cases or ask members to volunteer to present cases that pertain to their particular interest or expertise. Regardless of who is presenting the case, it is most beneficial to have a standard format and process to guide committee review and discussion.
During the case review process, the committee needs to make a number of key decisions:
For some cases, establishing a causal relationship between pregnancy and death will be straightforward. However, states who review deaths from injury (e.g. suicide, homicide, motor vehicle-related accidents) may find causality for such cases difficult to determine. Committees should rely on their members’ expertise to help assess case complexities and explore modifications or additional standards needed for the review of pregnancy-associated injury deaths. For deaths that are determined to be pregnancy-related, the committee should identify the critical factors associated with the death.
The committee's ability to craft recommendations closely relates to the case review process; in fact, recommendations are often discussed and identified at various parts of the committee’s discussion. Due to their importance and role in prevention of maternal deaths, they are discussed separately in the next section.