Opinion: Data, Death, and Delay — America’s Maternal Health Crisis – Undark Magazine

Report on Maternal Mortality in the United States and the Role of Maternal Mortality Review Committees (MMRCs)

Introduction

The United States ranks highest among 14 high-income industrialized nations for maternal mortality rates, with an average of 18.6 deaths per 100,000 live births as of 2023. Approximately 80% of these maternal deaths are considered avoidable. This alarming statistic highlights critical challenges in maternal health and underscores the importance of achieving Sustainable Development Goal (SDG) 3: Good Health and Well-being, which aims to reduce the global maternal mortality ratio.

Role and Importance of Maternal Mortality Review Committees (MMRCs)

Each U.S. state has established a Maternal Mortality Review Committee (MMRC) tasked with:

1. Reviewing pregnancy-related deaths.
2. Determining the avoidability of these deaths.
3. Providing recommendations to prevent future maternal mortality.

These committees are vital in addressing the doubling of maternal mortality rates between 1999 and 2021, aligning with SDG 3 targets to improve maternal health outcomes.

Challenges Faced by MMRCs in Certain States

Despite the critical role of MMRCs, several states have created obstacles that hinder their effectiveness:

Idaho

• Failed to renew MMRC funding in 2023, resulting in a three-year lapse in public reporting of maternal mortality data.
• Legislation passed in July 2024 (House Bill 399) reinstated funding and mandated public tracking of maternal mortality data.
• The MMRC resumed meetings in November 2024 and released its 2023 report, with plans to review data from 2022 and 2024.

Georgia

• Dissolved its MMRC in November 2024 due to alleged confidentiality breaches related to avoidable deaths following medication abortions.
• Reinstated the MMRC in March 2025 with anonymous committee members, reducing transparency.

Texas

• The MMRC has refused to review pregnancy-related deaths from 2022 and 2023, citing backlog prevention.
• This period followed the implementation of strict abortion restrictions, which correlated with a 56% rise in pregnancy-related deaths.
• Failure to review critical data undermines efforts to meet SDG 3 targets and protect maternal health.

Tennessee

• Releases annual reports with significant delays, with the latest covering 2020-2022 data.
• Quarterly reports ceased after the third quarter of 2023, limiting timely dissemination of maternal mortality trends to healthcare professionals.
• Tennessee currently has the highest maternal mortality rate among U.S. states.

Successful MMRC Models and Their Impact

Other states demonstrate the positive impact of active MMRCs, contributing to SDG 3 progress:

• California: Established an MMRC in 2006 and reduced pregnancy-related deaths by 50% by 2013.
• Illinois: Identified hemorrhaging as a leading cause of maternal deaths and mandated educational courses for obstetrics professionals, significantly reducing mortality.
• New Hampshire: Reviews each maternal death within 18 months, ensuring timely analysis and intervention.

Implications for Sustainable Development Goals

The gaps in maternal mortality data review and reporting impede progress toward several SDGs:

• SDG 3 (Good Health and Well-being): Delays and lapses in MMRC operations hinder efforts to reduce maternal mortality.
• SDG 10 (Reduced Inequalities): Lack of transparency and data may disproportionately affect vulnerable populations.
• SDG 16 (Peace, Justice, and Strong Institutions): Ensuring accountability and transparency in health data management is essential.

Conclusion and Recommendations

1. State governments must ensure continuous funding and operation of MMRCs to maintain timely review and public reporting of maternal mortality data.
2. Transparency in committee membership and findings should be upheld to foster trust and accountability.
3. Healthcare professionals must receive up-to-date data and recommendations to implement effective interventions.
4. Election of leaders committed to maternal health and SDG achievement is critical to reversing negative trends.

Addressing maternal mortality is not a political issue but a public health imperative aligned with the United Nations Sustainable Development Goals. Ensuring the health and safety of pregnant individuals is essential as birth rates increase and policies evolve.

Report prepared by Amy Grace Sullivan, graduate student in the Johns Hopkins Science Writing Program and agricultural research communications professional at Virginia Tech.

1. Sustainable Development Goals (SDGs) Addressed or Connected

1. SDG 3: Good Health and Well-being
   • The article focuses on maternal mortality rates in the United States, highlighting health system challenges and avoidable deaths related to pregnancy and childbirth.
2. SDG 5: Gender Equality
   • Maternal mortality is a critical issue affecting women’s health and rights, linking to gender equality and empowerment of women and girls.
3. SDG 16: Peace, Justice, and Strong Institutions
   • The article discusses the role of state governments and committees (MMRCs) in reviewing maternal deaths and making recommendations, touching on governance, transparency, and accountability.

2. Specific Targets Under Those SDGs Identified

1. SDG 3: Good Health and Well-being
   • Target 3.1: Reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030.
   • Target 3.8: Achieve universal health coverage, including access to quality essential health-care services.
2. SDG 5: Gender Equality
   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights.
3. SDG 16: Peace, Justice, and Strong Institutions
   • Target 16.6: Develop effective, accountable, and transparent institutions at all levels.
   • Target 16.7: Ensure responsive, inclusive, participatory and representative decision-making.

3. Indicators Mentioned or Implied to Measure Progress

1. Maternal Mortality Ratio (MMR)
   • The article explicitly mentions the maternal mortality rate in the U.S. as 18.6 deaths per 100,000 live births (2023), which is a key indicator under SDG 3.1.
   • Tracking and reporting of pregnancy-related deaths by state MMRCs serve as data sources to measure progress.
2. Data Transparency and Review Frequency
   • The article highlights the importance of timely data review and public reporting by MMRCs, implying indicators related to institutional transparency and effectiveness (SDG 16).
   • Frequency of maternal mortality reviews and publication of reports (annual, quarterly) can be considered process indicators.
3. Access to Reproductive Health Services
   • Though not quantified, the article implies indicators related to access to safe abortion and follow-up care, relevant to SDG 5.6 and SDG 3.8.

4. Table of SDGs, Targets, and Indicators

Source: undark.org