Maternal Mortality Review Committee reports decline in pregnancy‑related deaths in 2023; mental health and hemorrhage leading causes

The Idaho Maternal Mortality Review Committee (MMRC) presented its 2023 annual report to the Senate Health and Welfare Committee and recommended continued focus on substance‑use treatment access, telehealth for rural communities and efforts to identify system gaps in care for pregnant and postpartum women.

Oren Duffin, program director for the Health Professions Bureau and executive officer for the MMRC, told the committee that the MMRC reviewed records for cases identified by the Bureau of Vital Statistics. "For calendar year 2023, 13 cases were provided to the MMRC for investigation. Eleven of the 13 met criteria for inclusion committee review," Duffin said. Of those 11 pregnancy‑associated deaths, five were determined to be pregnancy‑related and six were pregnancy‑associated but not pregnancy‑related.

The MMRC found that mental‑health conditions and hemorrhage were the most common causes of pregnancy‑related deaths in 2023, accounting for 40 percent each. Duffin also said Idaho’s pregnancy‑related mortality ratio decreased from 40.1 deaths per 100,000 live births in 2021 to 22.6 in 2023; using a constrained federal methodology (MEC4), Idaho’s 2023 pregnancy‑related mortality ratio was 13.6 per 100,000 live births, below the federal HHS goal of 15.7 by 2030.

Duffin told the committee the MMRC found no evidence in the reviewed records that medical error or denial of care contributed to the 2023 deaths, and committee reviewers found no direct evidence that discrimination contributed to the deaths reviewed.

The MMRC recommended a set of actions, including investigation of access to evidence‑based treatments for pregnant and postpartum women (including those who are incarcerated), increased awareness of substance‑use disorder treatments for pregnant and postpartum women, expanded telehealth access for rural patients, and further attention to complications such as sepsis, preeclampsia and hemorrhage. The committee directed its only recommendation to the Idaho Legislature in 2023 to consider investigating access to treatments, including pharmacologic options for substance‑use disorder.

Committee members asked detailed questions about how committee members were selected, the credentials represented on the panel, and specific cases. Senator Wintrow pressed for more clinical detail on a reviewed death involving hemorrhage after a dilation and curettage procedure (D&C); Duffin said he would ask a clinician on the committee to provide further technical follow‑up and that the report contained no direct evidence of delay or deviation from standards of care in the reviewed records.

Duffin said the MMRC will continue reviewing earlier calendar years and the committee is scheduled to analyze 2022 and 2024 cases in future meetings. The MMRC will furnish an annual summary report to the legislature by Jan. 31 in accordance with statute.