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My colleagues @DrDaraDMendez @e_hernandez8 @Theresa_chapple and I share our view on what’s needed to reduce maternal mortality in this @Health_Affairs blog: implementation, representation, and legislation 1/ healthaffairs.org/do/10.1377/hbl… 
All of us currently serve or formerly served on maternal mortality review committees in the states of Minnesota, Pennsylvania, Indiana, Georgia, and Tennessee. 2/
In the United States, we are finally starting to develop the infrastructure we need to address maternal mortality, but we have a long way to go. We are in a bad place. 3/ npr.org/2017/05/12/528…
Maternal mortality review committees are the backbone of the data we have available to understand patterns of risk and to create corrective actions and re-shape structures to support the health and well-being of mothers. 4/ reviewtoaction.org/learn/what-mak…
But currently, there is huge variability across states in whether maternal mortality review occurs, and – if it does – how it is conducted, by whom, and with what authority. 5/ reviewtoaction.org/content/mmr-map
In late December, amidst partisan gridlock on Capitol Hill, the Preventing Maternal Deaths Act unanimously passed the House and Senate, and was signed into law on Dec 21. This bipartisan legislation is a good step forward, as described by @ByNinaMartin 6/ propublica.org/article/landma…
Yet, as @AlisonAnnYoung points out in @USAToday, this bill might not be enough, unless it’s properly funded and implemented, and unless it addresses gaps in systems and structures that render some folks particularly vulnerable. We agree. 7/ usatoday.com/story/news/inv…
The first step is effective implementation. As we write, “Key implementation decisions require attention to the heterogeneity of current maternal mortality review committees and could guide greater consistency and utility of the data that are collected.” 8/
The second step is representation. Those who are most affected by maternal mortality must be in leadership roles and positions of power to act on the information we learn about maternal mortality. This is critically important. 9/
That means including 1) people who have survived near-misses (like @kristenterlizzi), 2) family members of those who have lost loved ones (like @4kira4moms) 10/
It also means centering people from the communities who experience highest risks of maternal mortality, especially Black women, Native women, and rural women. Start by following the work of @BlkMamasMatter @doccrearperry @mclemoremr and others 11/
As we write, “The extent to which these voices are currently present in maternal mortality review committees is not known, but deserves a razor-sharp focus as the current legislation is implemented.” 12/
The third step is more legislation to address other key policy aspects of maternal mortality: racial equity, Medicaid policy, and geography. 13/
For example, last August, @SenKamalaHarris introduced the Maternal CARE Act, focused squarely on addressing structural racism’s pernicious effects on birth outcomes. 14/ harris.senate.gov/news/press-rel…
In September, @SenBooker put forth a bill designed to improve maternity care for Medicaid Beneficiaries. With Medicaid programs funding half of all births nationally, this is a necessary focus. (cc @emma_sandoe) 15/ booker.senate.gov/?p=press_relea…
And in October, @HeidiHeitkamp introduced comprehensive legislation to address gaps in data and access to maternity services for rural residents. Now, @SenTinaSmith is poised to move this work forward. (cc @ruralhealth) 16/ ruralhealthweb.org/blogs/ruralhea…
We write, “Discussions around these bills and other legislation addressing social determinants of maternal outcomes and health equity ought to be re-invigorated as the US establishes an infrastructure to combat maternal mortality across the nation.” 17/
This matters deeply to me, on a personal level. My family has been shaped by maternal mortality, and every person who knows the tragedy of losing a mom to childbirth deserves better. 18/18 [end] healthaffairs.org/doi/10.1377/hl…
