SMFM Calls for Minimum Standards of State-Based Maternal Mortality Review Committees

May 29, 2025

In a new position statement, the Society for Maternal-Fetal Medicine (SMFM) recommends that each state in the US have an active maternal mortality review committee (MMRC) and calls for each to meet a list of minimum standards. SMFM identified nine key criteria to help MMRCs review pregnancy-related deaths and develop strategies to address the high maternal mortality rate in the US.  

Data shows that maternal mortality is rising in the US, with a rate of 32.6 deaths per 100,000 live births in 2022 compared to 7.2 deaths per 100,000 births in 1987. The maternal mortality rate is much higher for non-Hispanic American Indian or Alaska Natives (106.3), and non-Hispanic Black individuals (76.9). According to research from the Centers for Disease Control and Prevention, more than 80 percent of pregnancy-related deaths are preventable.  "Although each state has an MMRC right now, there is wide variation from state to state on critical issues, including the minimum standards for reviewing and reporting data,” said Chloe Zera, MD, MPH, chair of the SMFM Health Policy and Advocacy Committee. “We need accurate, consistent data from MMRCs that we can compare across states to fully understand and address the growing crisis of maternal deaths.” 

MMRCs are state- and jurisdiction-level multidisciplinary groups that meet regularly to review deaths that occur during pregnancy and in the one-year postpartum period. These committees use medical, vital, and social service records to understand the factors contributing to maternal deaths and then develop recommendations to prevent future deaths.   

SMFM, based on expert consensus, recommends that all MMRCs adopt the following nine minimum standards:  

• Every state should maintain an active MMRC with the authority to obtain complete records. 

• MMRC should review all deaths occurring during pregnancy and within 1 year after the end of pregnancy.  

• MMRCs should set a goal of identifying cases within 1 year of death, reviewing those cases within 2 years of death, and disseminating a public report within 3 years of death. 

• Data should be reported for leading causes of death race, ethnicity, and other social factors, such as insurance type and geographic location. 

• MMRCs should report their data and findings in a standardized format using the CDC Maternal Mortality Review Information Application (MMRIA). 

• The CDC MMRIA committee decisions form section, “Contributing Factors and Recommendations for Action,” should be thoroughly considered and completed for every pregnancy-related case. 

• MMRCs should be nonpartisan bodies. 

• MMRC members should include representatives from various clinical and nonclinical disciplines, local organizations, and community members.  

• MMRCs should conduct interviews of deceased individuals’ families and close contacts whenever possible. 

Read the full position statement published in PREGNANCY. 

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About SMFM 
The Society for Maternal-Fetal Medicine (SMFM), founded in 1977, is the medical professional society for obstetricians who have additional training in high-risk, complicated pregnancies. SMFM represents more than 6,500 members who care for high-risk pregnant people and provides education, promotes research, and engages in advocacy to reduce disparities and optimize the health of high-risk pregnant people and their families. SMFM and its members are dedicated to optimizing maternal and fetal outcomes and assuring medically appropriate treatment options are available to all patients. 

Contact: Greg Phillips, Director of Communications, press@smfm.org