Actions recommended by the maternal mortality review committee (MMRC) can take many forms. Below are just a few examples of different MMRC success stories of putting recommendations into action. After reviewing these success stories, visit the Review to Action Resource Center by clicking the button below. There, you will find state and national partner resources that can be adapted, replicated, or tailored by states and jurisdictions to take evidence-based action to prevent maternal deaths.
The implementation of solutions and interventions identified by the MMRC is the ultimate goal of the review process – data collection and analysis alone do not have a purpose. Further, examples of population-based or targeted action taken or informed by the MMRC and an evaluation plan to demonstrate improved outcomes is the best way to ensure MMRC sustainability.
In New York, the New York State Department of Health (NYSDOH) identifies pregnancy associated deaths for the entire state but does not review deaths of New York City residents, whereas the New York City Department of Health and Mental Hygiene (NYCDOHMH) identifies and reviews pregnancy associated deaths of only New York City residents. Through their collaboration on the Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM) program, NYSDOH and NYCDOHMH have been able to combine their resources and case identification processes to ensure that all pregnancy associated deaths of New York State residents, including NYC residents, are accurately identified in a timely manner. For example, through NYSDOH’s participation in the State and Territorial Exchange of Vital Events (STEVE), NYSDOH Bureau of Vital Records identified additional pregnancy associated deaths of NYC residents that were not originally identified by NYCDOHMH, thus enhancing case ascertainment for the New York City review.
Wisconsin has developed an action plan for the operationalization of non-clinical perspectives within their multidisciplinary Maternal Mortality Review Committee (MMRC), including the addition of a Community Advocate and Community Member. The Wisconsin MMRC team has identified gaps in current committee membership and purposefully recruited new members. In addition, the team has worked to set new, non-clinical members up for success through providing a tailored orientation and support system in order to insure these new additional experts can be fully engaged in the committee reviews from the outset. Engagement of non-clinical perspectives into the process will better facilitate discussion and recommendations for action which address the entire spectrum of experiences a woman has over her life course and identify both the clinical and non-clinical contributors to her untimely death.
Indiana completed an ERASE MM peer-to-peer site visit to Wisconsin in early March 2020 to meet with a regional peer program to exchange learning and observe processes in action. One specific new strategy the Indiana MMRC program identified as a result of discussion with Wisconsin during the visit was enhancing pregnancy-associated case identification practices through a direct call to death certifiers in order to solicit confirmation of "pregnant at the time of death" status. Enhanced pregnancy-associated case identification processes help all jurisdictions ensure no woman's untimely death is not reviewed by a multidisciplinary, expert committee to generate recommendations for action.
Utah developed the geolocated Utah Maternal Mental Health Resource Network in which women and clinicians can search for providers that have been specifically trained in maternal mental health screening and treatment. The Utah Maternal Mental Health Resource Network was developed in response to the Utah MMRC recommendation “Educate providers on available resources and mental health specialists they can refer to” and data from other sources, such as PRAMS. Utah, alongside several community partners and legislators, gathered at the Utah State Capital Building on February 25th, 2020 to hold a press release regarding the launch of the website. In the first month of launching, the website received 1,300 visitors. The website is: https://maternalmentalhealth.utah.gov/.
Despite the multiple and layered challenges related to the novel coronavirus outbreak, MMRCs have demonstrated agility and a sustained commitment to their core programmatic work in order to maintain program data quality and timeliness. As a result of the additional resources available under the ERASE MM funding, programs were able to immediately obtain access to virtual meeting platforms to support core functions and maintain long-planned committee meeting schedules. The CDC-established national network of MMRCs permitted rapid dissemination of best practices for conducting reviews in a virtual environment.