The United States lauds itself as a global powerhouse that reigns first in every matter, and in at least one way, it’s right: The U.S. ranks first among 14 other high-income industrialized nations for the worst maternal mortality rates, according to the Commonwealth Fund, an independent health care research foundation. As of 2023, we have on average 18.6 deaths per 100,000 live births. Roughly 80 percent of those maternal deaths could be avoidable.
These statistics are why each state has a maternal mortality review committee, or MMRC, dedicated to reviewing pregnancy-related deaths, determining if those deaths were avoidable, and then providing recommendations to avoid those deaths in the future. The importance of these committees is highlighted by recent increases in maternal mortality, which more than doubled between 1999 to 2021.
Despite this alarming increase — and as reporting by Stateline has pointed out — Idaho, Georgia, Texas, and Tennessee have all created roadblocks for their committees to carry out their reviews and provide recommendations.
In 2023, Idaho failed to renew funding for its MMRC. The committee’s last report before disbanding used numbers from 2021, and although the state continued collecting pregnancy-related death data, those data were not made public. Funding for the committee wasn’t restored until July 2024, when the Idaho legislature passed House Bill 399, and the committee began meeting again in November. It has now released its 2023 maternal mortality report, with plans to review data from 2022 and 2024 this year, according to the Idaho Capital Sun.
Idaho’s legislation now explicitly requires the state to track and publicize maternal mortality data. This is a step in the right direction, but that doesn’t change the lapse in review that was allowed to occur for three years. How many people faced avoidable, pregnancy-related deaths during that period?
Georgia dissolved its MMRC in November 2024, claiming that the committee members violated their confidentiality agreements when the cases of Amber Thurman and Candi Miller, two women who died after being unable to access follow-up care following medication abortions, were shared with ProPublica. The committee had ruled that their deaths had been avoidable. In March 2025, after the committee had been inactive for four months, Georgia announced that it had reinstated its MMRC with new members whose identities are being kept anonymous, a notable change from when the names of committee members were public information.
Decisions not to review data and provide recommendations are even more confusing when considering the major successes that other states have had with their own MMRCs.
Texas’ MMRC hasn’t been dissolved; it has simply refused to review pregnancy-related deaths in the years following the overturn of Roe v. Wade. The committee argues that the decision not to review deaths from 2022 and 2023 helps to prevent case backlogs. But these two years followed the implementation of a total abortion restriction unless the pregnant person’s life is at stake, including the prosecution of anyone who provides an abortion outside of these guidelines. This restriction has already resulted in pregnancy-related deaths after patients were forced to wait for doctors and hospitals — fearing prosecution and backlash — to determine the best care. These two years of pregnancy-related death data are critical to review — especially knowing that in the first full year after severely restricting abortion, Texas saw a staggering 56 percent rise in pregnancy-related deaths, according to an analysis by the Gender Equity Policy Institute. To have that information and then decline to review and provide recommendations on how to avoid pregnancy-related deaths is not in line with a state that cares about its people.
Similarly to Texas, Tennessee’s MMRC releases annual reports using years-old data. The 2024 report, for example, reviewed maternal deaths from 2020 through 2022. Tennessee’s MMRC has also released short quarterly reports to help give obstetrics professionals timely, relevant information on case trends in maternal mortality. But the last quarterly report came out in the third quarter of 2023, according to the state’s website. For the past five quarters, Tennessee’s obstetrics professionals have not received timely information they may need to prevent maternal mortality. This news comes alongside maternal death data from the Centers for Disease Control and Prevention for 2018 to 2022, which estimates that Tennessee has the highest maternal mortality rate of any U.S. state.
Decisions not to review data and provide recommendations are even more confusing when considering the major successes that other states have had with their own MMRCs. California was one of the first states to install an MMRC in 2006. By 2013, it had halved its pregnancy-related deaths. Similarly, Illinois drastically reduced pregnancy-related deaths after its MMRC found that most deaths were related to hemorrhaging and mandated that obstetrics professionals take an educational course on it. Other states, like New Hampshire, review each death within 18 months, rather than not reviewing some data or reviewing data from many years past.
Long gaps in the review or publication of pregnancy-related data robs obstetrics professionals of recommendations that could help save the lives of their patients, and it robs patients of an understanding of their state’s ability to prevent pregnancy-related deaths. And as states with a total or six-week abortion ban see an increase in childbirth, as well as the U.S. Department of Transportation promoting higher birth rates, it seems counterintuitive to not ensure the health and safety of those giving birth.
This argument isn’t about political ideals; it’s about our newfound willingness to ignore problems that we have previously addressed for years. It is not enough to collect maternal mortality data; our state governments must ensure that MMRCs are always operational and prepared to review data to make life-saving recommendations. To do that, we must elect leaders that actively put our best interests forward and take all necessary actions to ensure our wellbeing. Maybe then the United States will finally be first for the right reasons.
Amy Grace Sullivan, a Mississippi native, is a graduate student in the Johns Hopkins Science Writing Program and works in agricultural research communications at Virginia Tech.