The quality of a case review and deliberations about individual deaths directly align to the expertise and commitment to the mission of the review by committee members serving on the MMRC. Committees should have a chair to provide overall leadership and vision for the group, members to inform the case review, and support from abstractors, coordinators, epidemiologists, and database managers.

In some states, the legislation that authorizes the MMRC outlines the process through which committee members can be identified and appointed. The authorizing legislation may specify disciplines that must serve on the committee, or more specifically, may mandate that representatives of organizations serve on the committee (e.g. the state Medicaid agency, hospital leadership). For states that have flexibility in the appointment of committee members, individuals responsible for establishing the MMRC may use an array of tactics to identify potential committee members, such as an open call for nominations or direct invitation to key stakeholder groups.

There is no recommended number of members serving on the MMRC. The total number of MMRC members is contingent upon the scope of the review (e.g. whether or not the review includes injury-related deaths), the number of deaths reviewed by the committee, and the committee’s mission (e.g. to advance health equity). Collectively, the members of an MMRC should be able to examine the clinical, social, and environmental factors that led to a maternal death. A diverse review committee comprised of members who represent a variety of clinical and psychosocial specializations, members working in different areas of the respective state, representatives of rural and urban or different race/ethnic backgrounds in that state, and disciplines such as social workers and community organizations can enhance the depth of reviews. MMRCs must balance breadth of expertise with the ability to reach consensus during case reviews.

A recommended membership strategy is to identify and recruit members who have skills across more than one role and can wear multiple hats on the committee. This flexibility can serve a great need because all members may not be able to participate in every meeting. Additionally, the frequency of meetings will depend on the purpose, scope, and case load of a review committee.

OrganizationsCore DisciplinesSpecialty Disciplines
Academic InstitutionsAnesthesiologyCardiology
Behavioral Health AgenciesFamily MedicineClergy
Blood BanksForensic PathologyCommunity Leadership
Community AdvocateMaternal Fetal Medicine/ PerinatologyCritical Care Medicine
Community Birth WorkersNurse MidwiferyNutrition
Federal Qualified Health CentersObstetrics and GynecologyEmergency Response
FIMR/CDR ProgramsPatient SafetyEpidemiology
Healthy Start AgenciesPerinatal NursingGenetics
Homeless ServicesPsychiatryHome Nursing
Hospitals/ Hospital AssociationsPublic HealthLaw Enforcement
Private and Public InsurersSocial WorkMental Health Provider
Professional Assoc. State Chapters Pharmacy
Rural Health Associations Public Health Nursing
State Medical Society Quality/Risk Management
State Medicaid Agency Addiction Counseling
State Title V Program  
State Title X Programs   
Tribal Organizations   
Violence Prevention Agencies  

Maintaining a comprehensive MMRC is essential to influence maternal outcomes. To retain members, MMRC leaders can implement the following strategies:

  • Offer incentives (e.g., continuing medical education credits)
  • Provide food and beverages during committee meetings
  • Recognize members’ participation (with certificates, regular expressions of gratitude, features in newsletter articles, etc.)
  • Establish term limits for members, if desirable to the committee

Some states may also invite key stakeholders to assist with reviews and serve on a review temporarily. To vet stakeholders or replacement members, MMRC leaders can implement the following strategies:

  • Administer an application
  • Have current MMRC members vet new, potential members
  • Contact professional organizations for MMRC member recommendations