End the Scourge of Preventable Maternal Deaths

Every year in the United States, hundreds of women die during or immediately after childbirth. American maternal mortality rates have risen by 27 percent over the past fifteen years—far more than in other industrialized nations, where maternal mortality rates have been on the decline. Over half of maternal deaths and 50,000 annual near-death experiences related to childbirth are entirely preventable. With a Maternal Mortality Review Board states can put experts in charge of taking action to prevent these devastating, and unnecessary deaths and near-death experiences.

Frequently Asked Questions
Who does this help?
This policy helps families by preventing unnecessary death and life-threatening complications during childbirth. Mothers, new families and all who love them will be positively impacted by reducing maternal death and childbirth complications.
Is this costly to the state?
No. By identifying and then addressing the causes of maternal mortality, states can save immensely on healthcare costs.
  • Families
  • Healthcare providers
  • Anti-poverty advocates
Model Policy
This act shall be known as the Maternal Mortality Prevention Act
To prevent maternal mortality through a Maternal Mortality Review Board.

(a) There is hereby established a Maternal Mortality Review Board, which shall be tasked with annually reviewing and reporting on maternal death rates and the causes of maternal death in STATE, and facilitating adoption of solutions that will improve maternal outcomes in STATE.

(b) The Board shall be composed of a minimum of twenty-one and a maximum of twenty-five members that the highest-ranking state health official (“Health Official”) shall appoint to serve three-year terms. The Health Official shall serve as Chair.
-(i) Members shall be appointed from geographic areas throughout the state with knowledge of maternal mortality and severe maternal morbidity, including:
–(1) representatives of hospitals and other birthing facilities;
–(2) obstetrical providers;
–(3) nursing providers;
–(4) the Commissioner or another suitable representative of STATE Departments and Offices with knowledge, data, or relevant jurisdiction over aspects of the maternal care process;
–(5) at least two representatives from communities in STATE most impacted by maternal death;
–(6) representatives of an association of perinatal health care providers; and
–(7) other health care professionals and representatives that the Health Official deems appropriate.
-(ii) In appointing members to the Board, the Health Official shall follow best practices as outlined by the Centers for Disease Control and Prevention in the federal Department of Health and Human Services.
-(iii) All initial appointments to the Board shall be made within 60 days after enactment of this act.
-(iv) Board members shall serve without compensation or perquisite arising from their service.

(c) The Health Official shall call the first Board meeting as soon as practicable following the appointment of a majority of Board members, and in no case later than six months after enactment of this Act. Thereafter, the Board shall meet pursuant to a schedule that is established during the first Board meeting, but no less than 4 times per calendar year. The Board may additionally meet at the call of the Chair.

(d) A majority of the total number of members appointed to the Board shall constitute a quorum for the conducting of official Board business. Any recommendations of the Board shall be approved by a majority of the members present.

(e) In addition to any relevant national or publicly available data, the Board shall have access to de-identified data sets on in-state maternal mortality incidents. De-identified data sets shall be provided annually by the appropriate DEPARTMENT.
-(i) The data sets provided by the DEPARTMENT and all activities or communications of the commission shall comply with all state and federal laws relating to the transmission of health information.
-(ii) Such data sets shall contain all relevant information on instances of maternal mortality that occurred in STATE during the previous calendar year.
-(iii) Such data sets shall have all personally identifying information removed. The information to be redacted from data sets includes, but is not limited to:
–(1) names;
–(2) street address;
–(3) facial photographs;
–(4) phone numbers;
–(5) social security numbers;
–(6) and other personal information not relevant to the diagnosis, treatment, or care provided during a fatal maternity incident.
-(iv) Each member of the Board shall sign a confidentiality agreement regarding personally identifying information that the DEPARTMENT deems necessary to the Board’s objective, or that is disclosed to the Board inadvertently. A Board member who knowingly violates the confidentiality agreement commits a class 3 misdemeanor.
-(v) Members of the Board are not subject to subpoena in any civil, criminal, or administrative proceeding regarding the information presented in or opinions formed as a result of a meeting or communication of the Board; except that this subsection (e)(v) does not prevent a member of the Board from testifying regarding information or opinions obtained independently of the Board or that are public information.
-(vi) Notes, statements, medical records, reports, communications, and memoranda that contains, or may contain, patient information are not subject to subpoena, discovery, or introduction into evidence in any civil, criminal, or administrative proceeding, unless the subpoena is directed to a source that is separate and apart from the commission. Nothing in this section limits or restricts the right to discover or use in a civil, criminal, or administrative proceeding notes, statements, medical records, reports, communications, or memoranda that are available from another source separate and apart from the Board and that arise entirely independent of the Board’s activities.

(f) The Board shall:
-(i) review each maternal mortality and severe maternal morbidity incident in the state using the de-identified data sets that the DEPARTMENT provides or any other lawful source of relevant information;
-(ii) review research that substantiates the connections between a mother’s health before, during, and between pregnancies, as well as that of her child across the life course;
-(iii) outline trends and patterns relating to maternal mortality and severe maternal morbidity in STATE;
-(iv) review comprehensive, nationwide data collection on maternal deaths and complications, including data disaggregated by race, geography, and socioeconomic status;
-(v) review any information provided by the DEPARTMENT on social and environmental risk factors for women and infants, especially women and infants of color;
-(vi) review research to identify best practices and effective interventions for improving the quality and safety of maternity care and compare those to practices currently in use in STATE;
-(vii) review research to identify best practices and effective interventions, as well as health outcomes before and during pregnancy, in order to address pre-disease pathways of adverse maternal and infant health and compare those to practices currently in use in STATE;
-(viii) review research to identify effective interventions for addressing social determinants of health disparities in maternal and infant health outcomes;
-(ix) serve as a link with maternal mortality review teams throughout the country and participate in regional or national maternal mortality review team activities;
-(x) request input and feedback from interested and affected stakeholders; and
-(xi) compile reports, using aggregate data based on the cases that the DEPARTMENT identifies for reporting. The Board shall compile these reports on an annual basis in an effort to further study the causes and problems associated with maternal mortality and severe maternal morbidity and shall distribute these reports on DEPARTMENT’s website and to the legislature, government agencies, health care providers and others as necessary to reduce the maternal mortality rate in the state.
-(xii) Annually produce a report highlighting recommended solutions and steps that could be taken in STATE to reduce maternal mortality, morbidity, and near-death or life-threatening maternal incidents. These reports shall include recommendations to assist health care providers, relevant DEPARTMENTs and lawmakers in reducing maternal mortality, morbidity, and near-death and life-threatening maternal incidents. The Board shall distribute these reports on the DEPARTMENT’s website and to the legislature, government agencies, health care providers and others as necessary to reduce the maternal mortality rate in the state.

(g) The Board may:
-(i) form special ad hoc panels to further investigate cases of maternal death resulting from specific causes when the need arises; and
-(ii) perform any other function as resources allow to enhance efforts to reduce and prevent maternal mortality and severe maternal morbidity in the state.

(h) Reports prepared by the Board shall detail which recommendations state DEPARTMENTS or others can pursue on their own without additional legislative action. Unless precluded by state or federal law, DEPARTMENTS may begin to enact recommendations immediately and shall issue public replies to Board reports indicating whether recommendations can or will be acted on, or any obstacles faced by DEPARTMENT in acting upon them.

(i) For recommendations that would require additional action by the legislature, the Board report shall include in the report specific requests and outlines of legislative action needed, including budget requests.