Maternal Mortality Review Committee

The Maternal Mortality Review Committee (MMRC) is an advisory body to the Idaho State Board of Medicine. Reconstituted in 2024, the committee’s purpose is to identify, review, and analyze maternal deaths and determine if the pregnancy was incidental to, or a contributing factor in, the mother’s death. The Idaho Department of Health and Welfare Bureau of Vital Records and Health Statistics provides the MMRC staff with the names of the women that qualify for MMRC review for a given year.

Q: Do the following factors contribute to cases and are they reviewed: hemorrhage screening, D&C
procedures, delays in care, misdiagnosis, physician shortages in Idaho, OB department closures in Idaho, and
recently enacted laws impacting medical practice?
A: The Idaho Maternal Mortality Review Committee reviews each maternal death methodically, looking for any
factor that may have contributed to the death. These include, as a matter of discussion, whether appropriate
diagnoses were made, procedures performed, and screenings completed based on the acceptable community
standard of care. Patient-specific findings are used to develop the report and its accompanying
recommendations, which also assess whether instances of suboptimal care or treatment delays were present.
The committee does not evaluate provider competency, triage protocols, validity of hospital care pathways,
standard operating procedures, or other broad healthcare factors beyond the purview of the MMRC; rather,
its focus is on the specific maternal death being investigated. The committee is given a narrow scope and as
such will not comment on broader healthcare concerns in the state of Idaho.
Based on the available records reviewed, the committee found that neither delays in care nor medical error
were contributing factors in the 2023 maternal deaths. This determination may change in futures years based
on the available evidence and findings of the committee.

Q: What was the reason for the absence of a “House” presentation of the most recent MMRC
Legislative Report, and could you clarify the legislative process regarding this matter?
A: The finalized 2023 MMRC report was provided to the leadership in the Idaho Legislature via email. An offer
was extended to both the Idaho House and Senate Health and Welfare Committees for an oral presentation of
the report findings. Only the Idaho Senate Committee accepted the offer and scheduled a presentation date.
The MMRC appreciated this opportunity to highlight its findings and answer questions the legislature had.

Questions for the MMRC may be submitted via email at MMRC@dopl.idaho.gov. 

Maternal Death:

• As defined by Health and Human Service’s Office of Disease Prevention and Health Promotion: The annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy. This definition is used to calculate the MICH-04 Obstetric Caused Pregnancy-Related Ratio.
• As defined by the Idaho Maternal Mortality Review Committee (MMRC): The death of a woman from any cause during pregnancy or within 365 days following the end of the pregnancy.

Maternal Mortality Review Committee (MMRC): multidisciplinary group that convenes at the state or local level to comprehensively review deaths that occur during or within 1 year of the end of pregnancy. Each MMRC is designed to identify ways to improve behaviors, health and healthcare delivery before, during, and after pregnancy.

MICH-04 Pregnancy-Related Ratio: Used by the U.S. Department of Health and Human Services as a quantitative measure of the number of Pregnancy-Related obstetric caused deaths per 100,000 live births.2 This counting methodology aligns with the international definition of maternal death.

• Numerator: number of female deaths due to obstetric causes (ICD-10 codes: A34, O00-O95, O98-O99) while pregnant or within 42 days of being pregnant.
• Denominator: Total number of live births per year in Idaho.

Pregnancy-Associated Death (PAD): The death of a woman from any cause, while pregnant or within one year of being pregnant, regardless of the duration and location of the pregnancy. represents the total number of maternal deaths within the state of Idaho and is subdivided into two categories:

Pregnancy-Associated but not related Death: The death of a woman due to a non-pregnancy related cause.

Pregnancy-Related Death (PRD): A Pregnancy-Associated Death resulting from one of the following:

• Complications of the pregnancy itself.
• A chain of events initiated by the pregnancy.
• Aggravation of an unrelated condition by the physiological effects of pregnancy.

Pregnancy-Related Mortality Ratio (PRMR): Used by most MMRCs to calculate the number of Pregnancy-Related Deaths (women that were pregnant or within 365 days of being pregnant) per 100,000 live births

• Numerator: number of Pregnancy-Related Deaths per year
• Denominator: Total number of live births per year in Idaho

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