Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM)

Maternal Mortality Review Committees (MMRCs) are multidisciplinary committees in states and cities that perform comprehensive reviews of deaths among women within a year of the end of a pregnancy. They include representatives from public health, obstetrics and gynecology, maternal-fetal medicine, nursing, midwifery, forensic pathology, mental and behavioral health, patient advocacy groups, and community-based organizations. CDC works with MMRCs to improve review processes that inform recommendations for preventing future deaths.

The Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM) Program supports agencies and organizations that coordinate and manage Maternal Mortality Review Committees.

Support for MMRCs

CDC has made 24 awards, supporting 25 states for the Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM) Program. This funding directly supports agencies and organizations that coordinate and manage Maternal Mortality Review Committees to identify, review, and characterize maternal deaths; and identify prevention opportunities. This work will:

  • Facilitate an understanding of the drivers of maternal mortality and complications of pregnancy and better understand the associated disparities.
  • Determine what interventions at patient, provider, facility, system, and community levels will have the most effect.
  • Inform the implementation of initiatives in the right places for families and communities who need them most.

States Funded Through ERASE MM

Map of the following states participating in ERASE MM: Alaska, Arizona, California, Colorado, Connecticut, Delaware, Illinois, Indiana, Kansas, Louisiana, Mississippi, Missouri, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Utah, Washington, Wisconsin, Wyoming (awarded under Utah).

Tools and Resources for MMRCs

Maternal Mortality Review Information Application (MMRIA, or “Maria”) is a data system designed to facilitate MMRC functions through a common data language. CDC, in partnership with maternal mortality reviews and subject matter experts, developed the system and it is available to all MMRCs. Standardized data collection is a first step toward fully understanding the causes of maternal mortality and eliminating preventable maternal deaths. MMRIA helps MMRCs organize available data and begin the critical steps necessary to comprehensively identify and assess maternal mortality cases. MMRIA provides the following:

  • A repository for the collection of clinical and non-clinical information surrounding a woman’s life and death, which can help facilitate review by a jurisdiction-based maternal mortality review committee.
  • Documentation of committee deliberations on1) whether the death was related to pregnancy; 2) if it could have been prevented; 3) factors that contributed to the death; and 4) recommendations to prevent future deaths.
  • Standardized indicators, common to most pregnancy-related deaths that can be used for surveillance, monitoring, and examining maternal mortality.

Review to Actionexternal icon is a website for promoting best practices in maternal mortality review. It assists jurisdictions without an MMRC in gathering resources, tools, and provides support for establishing a review committee. In addition, it connects jurisdictions with an established MMRC to best practices, resources, and support; and raises awareness of the critical role MMRCs play in eliminating preventable maternal deaths.

Pregnancy-Related Deaths: Data from 14 US Maternal Mortality Review Committees, 2008–2017 is a data brief released by CDC with updated data from 14 MMRCs. Key findings included the following:

  • Approximately 2 out of 3 pregnancy-related deaths occur outside of the day of delivery or the week postpartum.
  • The leading causes of pregnancy-related deaths varied by race/ethnicity.
  • Approximately 2 out of 3 deaths were determined to be preventable.

Kramer M, Strahan A, Preslar J, Zaharatos J, St Pierre A, Grant J, Davis N, Goodman D, Callaghan W. Changing the conversation: applying a health equity framework to maternal mortality reviewsexternal icon. Am J Obstet Gynecol.external icon 2019 Dec;221(6):609.e1-609.e9.

St Pierre A, Zaharatos J, Goodman D, Callaghan WM. Challenges and opportunities in identifying, reviewing, and preventing maternal deaths.external icon Obstet Gynecol. 2018;131(1):138–142.

Zaharatos J, St Pierre A, Cornell A, Pasalic E, Goodman D. Building U.S. capacity to review and prevent maternal deathsexternal icon. J Womens Health (Larchmt). 2018;27(1):1–5.

Shellhaas CS, Zaharatos J, Clayton L, Hameed AB. Examination of a death due to cardiomyopathy by a maternal mortality review committeeexternal icon. Am J Obstet Gynecol. 2019 ;221(1):1–8.