In an effort to lower the country’s continuously high rates of maternal death, governmental panels of specialists look into and learn from each mother’s passing.
Maternal mortality review committees are groups that often operate in secret and without public notice. However, in three states with stringent abortion regulations, that hasn’t been the case lately.
After details of the fatalities under review were leaked to the news agency ProPublica, Georgia fired every member of its committee in November. The Texas committee would not consider cases from 2022 and 2023, the first two years following the state’s ban on almost all abortions, according to a Washington Post report a few days later. Idaho reinstated its panel earlier this year after allowing it to dissolve in 2023.
According to epidemiologist Michael Kramer, director of Mercer University’s Center for Rural Health and Health Disparities in Georgia, they are now more of a lightning rod than they were previously.
Maternal mortality review panels around the country do the following, and this is what could happen next:
What are they?
According to David Goodman, head of the maternal mortality prevention team at the U.S. Centers for Disease Control and Prevention, maternal mortality review committees are crucial because they are the most thorough source of data on maternal mortality that we have.
Whether or whether the deaths are directly related to the pregnancy, the panels examine deaths that take place during pregnancy or within a year after it ends. Deaths may result from car accidents, drug overdoses, or hemorrhage during childbirth.
According to Kramer, the objective is to investigate maternal fatalities and assist in determining what might be done to address them.
These committees exist in every state, a few localities, and Puerto Rico. They may consist of OB-GYNs, physicians who specialize in maternal-fetal medicine, nurses, midwives, specialists in mental and public health, and representatives of patient advocacy organizations. The CDC advises that most have representatives from multiple areas of expertise.
Members are chosen in a variety of ways, including through applications, letters of interest, and invitations to serve.
Kramer stated that political motivations should not influence the selection process because it is hard to fully comprehend what is going on if certain information or viewpoints are often left out.
What do they think about death?
First, by reviewing death certificates and searching for a pregnancy checkbox or a linked cause of death, the panels collaborate with state vital statistics offices and epidemiologists to find pregnancy-related deaths. They might also look through obituaries, media accounts, hospital discharge data, and links to birth and fetal death records.
After identifying cases, they gather as much data as they can, including autopsy reports, hospital and social service records, prenatal care records, and family interviews. Committee members read through the case narratives that professional abstractors condense from all of this. The majority follow a standardized review procedure created by the CDC, and the organization offers assistance and direction to all panels.
They take into account things like: Was the death connected to pregnancy? What was the fundamental reason? Could it have been avoided? What were the contributing factors?
Committee members and those who submit information about the deaths are generally protected by state privacy laws.
The organizations then release reports to the public that include general conclusions, trends, and suggestions but do not identify mothers or hospitals. A few years or longer after the deaths, some come out.
According to Goodman, 151 of the studies’ recommendations were put into practice nationwide in 2023 by hospitals, communities, lawmakers, and medical professionals.
What about Texas, Idaho, and Georgia?
According to the state public health commissioner, Georgia will reestablish its committee by implementing a new application procedure.
In an email to The Associated Press, Texas Department of State Health Services spokesman Lara Anton stated that the committee has been examining deaths from 2021 and would begin discussing 2024 cases at its subsequent meeting.
It takes a long time to review cases, and lawmakers have requested more recent statistics. Mother and child health epidemiologists will continue to study and publish data for 2022 and 2023, Anton added, adding that starting the next review cycle with 2024 cases will allow us to give that in the next report.
In Idaho, the state board of medicine, which grants medical licenses, now oversees the reconstituted review committee rather than the state’s health and welfare department. The medical board’s spokesperson, Bob McLaughlin, stated that it will function as it always has. Members will release a report by January 31 after their first meeting in November. According to McLaughlin, the first report will only include 2023 cases because the legislature requested the most recent data. The panel will then examine 2022 deaths.
Goodman stated that while just 20 states had review committees in 2015, he is delighted that all states now have them.
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