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Michigan Maternal Mortality Surveillance (MMMS) Program - Frequently Asked Questions


Who is considered a maternal death?
A maternal death is the death of a women who is currently pregnant or was pregnant within 365 days of death.

How are maternal deaths classified?
Maternal deaths are classified into two distinct categories:
1. Pregnancy-associated, not related death = the death of a women while pregnant or within 1 year of termination of pregnancy, irrespective of cause
2. Pregnancy-related death = the death of a women while pregnant or within 1 year of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by her pregnancy or its management, but not from accidental or incidental causes

Who is required to be a mandatory maternal death reporter?
Michigan law states that a physician or an individual in charge of a health facility who is present for or is aware of a maternal death must submit information regarding that death at the time and in the manner specified or approved by the department for inclusion in the health information system established under Section 2616 of Public Act 479 of 2016.

Michigan Maternal Mortality Mandatory Reporting Guidance Letter

When do you report?
All maternal deaths must be reported immediately after they occur.

How do you report?
To report, please fill out the Michigan Maternal Mortality Mandatory Maternal Death Reporting Form. The completed form and associated medical records should be sent to the department address listed at the bottom of the form. All details surrounding the maternal death (e.g., discharge summaries, autopsy reports, EMS reports, etc.) should be submitted with the report form.

How are cases identified?
The Division of Vital Records and Health Statistics prepares the Michigan Maternal Mortality File by identifying cases in four ways: 1) death certificates with pregnancy-related Internal Classification of Disease codes [ICD-10: A34, O00-O95, O98-O99]; 2) death certificates with the pregnancy checkbox indicated; 3) death certificates for women who were also identified as having been pregnant in the year prior to death through linkages to the Michigan Resident Live Birth and the Michigan Resident Fetal Death Files; and 4) mandatory reporting under the Public Act 479 of 2016 by a health professional.

How is the MMMS Program able to access maternal death data under the Health Insurance and Accountability Act (HIPPA)?
MDHHS is a public health authority as defined by HIPPA, Privacy Rule [45 CFR 164.501]. Pursuant to 45 CFR  164.512(b) of the Privacy Rule, covered entities, such as your organization, may disclose, without individual authorization, protected health information to a “...public health authority that is authorized by law to collect and receive such information for the purpose of preventing or controlling disease, injury, or disability, including, but not limited to, the reporting of the disease, injury, vital events such as birth or death and the conduct of public health surveillance, public health investigations…” The MMMS Program is able to obtain related health information regarding a maternal death for the purpose of public health investigation of maternal deaths.

Michigan Maternal Mortality Surveillance Memo of Authority

What are the Michigan Prosperity Regions?
The Michigan Regional Prosperity Initiative is an effort to streamline the collaborative efforts across Michigan to achieve economic prosperity.


What is mortality?
Mortality is another word for death. Maternal mortality is the death of a woman during pregnancy, at delivery, or within a year after the end of her pregnancy.

What are some causes of maternal death?
Cardiovascular diseases (heart diseases), Infection or sepsis, Hemorrhage (excessive blood loss), Cardiomyopathy (heart muscle disease), Thrombotic pulmonary embolism, Hypertensive disorders of pregnancy, Cerebrovascular (blood flow to the brain) accidents, Amniotic fluid embolism, Anesthesia complications, Homicide, Suicide, Substance abuse, and Motor vehicle accidents.

How can maternal deaths be prevented?
Many things influence pregnancy-related health outcomes. Below is a list of protective factors for women of reproductive age:
1. Maintain a healthy diet and weight
2. Be physically active
3. Avoid substance use
4. Prevent injuries
5. Maintain safe and healthy relationships
6. Address any health problems before getting pregnant
7. Visit your healthcare provider at recommended time periods to discuss if or when you are thinking about getting pregnant
8. Early recognition and management of complications if they arise during pregnancy
9. Early initiation of prenatal care by pregnant women, and continuous monitoring of pregnancy by health providers.


Visit our MMMS resource page for more information on how to achieve these protective factors.

How many maternal deaths are there in Michigan?
Each year, approximately 90 Michigan women die during pregnancy or within one year of their pregnancy.

What if I want to ask more questions about maternal mortality in Michigan?
Please feel free to contact Melissa Limon-Flegler, the MMMS Program Coordinator, at 517-373-1817 or with all of your maternal mortality related questions.


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