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Michigan Maternal Mortality Surveillance (MMMS) Program - Committee Recommendations

Michigan's Maternal Mortality Surveillance (MMMS) Project is a state-level structured process by which a multidisciplinary Maternal Mortality Review Committee (MMRC) convenes to identify and review cases of maternal death that occur during pregnancy, at delivery, or within one year of the end of pregnancy. Causes of death are determined during the review process and policy recommendations are made to prevent future deaths.

Recommendations for implementing interventions and prevention strategies that address equity are particularly relevant for eliminating Michigan's pronounced racial disparities in maternal death rates. The recommendations outlined by the committee are increasingly geared to include improved understanding of the impacts of social, economic, cultural, and environmental factors on health status.

Below are the MMMS/MMRC priority recommendations (abbreviated) which meet the following criteria:

  • Highest prioritization score
  • Primary and/or secondary prevention
  • Large and medium impact level
  • Recommendations that have been made for more than one case

Promoting Actions to Improve Maternal Systems of Care: Michigan Maternal Mortality Surveillance (MMMS) and Detroit Maternal Mortality and Vitality Review Team (MMVRT) Aligned Recommendations
Michigan Maternal Mortality Surveillance (MMMS) and Fetal Infant Mortality Review (FIMR) Aligned Recommendations
Michigan Maternal Mortality Surveillance Report: A Focus on Contributing Factors & Review Team Recommendations

MMMS/MMRC Priority Recommendations

  1. The committee and MI-AIM staff and will work toward full implementation of the AIM safety bundles: Obstetric Hemorrhage and Severe Hypertension in Pregnancy while working to adopt & implement the Safety Bundles:
    • Obstetric Care for Women with Opioid Use Disorder (+AIM)
    • Safe Reduction of Primary Cesarean Birth (+AIM)
    • Mental Health: Depression and Anxiety (+AIM)
    • Maternal Venous Thromboembolism (+AIM)
    • Sepsis bundle (CMQCC)
    • Improving Health Care Response to Cardiovascular Disease in Pregnancy and Postpartum (CMQCC)

  2. Partner with MDHHS Family Planning Program and other related entities to promote increased contraceptive access and create and implement an education campaign focused on contraceptive access, including LARC.

  3. Implement substance use screening (including alcohol and tobacco) at first prenatal visit, throughout pregnancy and postpartum visits.
    • Providers need education on the next step for positive drug screens and guidance on early detection/intervention of substance use disorders.
    • When talking to patients about their substance use, providers should use an empathetic and objective approach.

  4. Increase access to home visiting/family support services for all pregnant and postpartum women in Michigan.

  5. Enact improved polices regarding; the completion of depression screening once a trimester and at postpartum visits and early follow up and referral for women who screen positive.

  6. Facilitate a partnership between MI AIM and other medical organizations to increase access to provider education (on topics such as how to provide care coordination, what resources exist, etc.)

  7. Partner with Family Planning and Chronic Disease to provide contraceptive counseling and reproductive life planning education to providers working with individuals of reproductive age.

  8. Implement a comprehensive state-wide education initiative to address pregnancy and its intersection with mental health, sexual abuse, IPV, trauma, substance use, and chronic health conditions as well as its increased occurrence in populations of women who are most vulnerable and marginalized.

  9. Promote the National Suicide Prevention Lifeline and support expanding the capacity of the program in Michigan.

  10. Women need wrap-around services to help align systems of care and transform every interaction into an opportunity for change.

The full list of MMMS/MMRC recommendations can be found at the link below.

Michigan Maternal Mortality Surveillance - Review Committee Recommendations (as of FY21 Q2)

For more information about the Michigan Maternal Mortality Surveillance Program, please contact Melissa Limon-Flegler, MMMS Program Coordinator, at (517) 284-4230 or


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