Idaho could resurrect a review of pregnancy-related deaths. But doctors are skeptical

Six months after Idaho lost its Maternal Mortality Review Committee, a volunteer cohort of medical and public health experts that assess deaths during and shortly after pregnancy, a lawmaker is attempting to revive review of that data.

But former committee members told the Idaho Statesman the new bill lacks many of the safeguards and other requirements of the previous law, potentially rendering it less effective and exposing committee members and patient information.

“There needs to be layers of protection for patients and the people participating in the review,” Dr. Amelia Huntsberger, an OB-GYN and former committee member, said in an interview. “Those are things I don’t yet see in the bill.”

Established in 2019 using federal funds, the committee reviewed the deaths of pregnant people and new mothers with the goal of identifying mortality trends and preventing future deaths. House Majority Leader Megan Blanksma, R-Hammett, introduced a bill that would instead direct the state Board of Medicine to collect and review data on maternal deaths and report its annual findings.

Physicians told the Statesman they’re excited to see the Legislature taking up the topic of maternal mortality, though the bill needs some adjustments.

Huntsberger said she remains skeptical that lawmakers would pass any law to renew review of pregnancy-related deaths. Republicans last year allowed the review committee to expire, leaving Idaho as the only state in the country without a mandate to review maternal deaths.

Doctors say bill doesn’t provide protection

In 2019, Idaho adopted a new law that established the state’s now-defunct Maternal Mortality Review Committee. The law outlined the medical professionals to participate in the committee, the information it would collect and have access to, and the confidential and privileged nature of the committee. The committee was set to expire in June 2023.

Last year, shortly after Idaho’s strict abortion bans were triggered, Rep. Dori Healey, R-Boise, proposed eliminating the expiration date of the committee. Her bill stalled in a legislative committee after lawmakers and lobbyists from the Idaho Freedom Foundation questioned the value of Idaho-specific maternal mortality data. Healey later withdrew the bill. On Tuesday, she introduced a new bill to reinstate the committee.

Blanksma’s bill this year is a departure from the previous structure of the Maternal Mortality Review Committee. Her legislation would put the state Board of Medicine in charge of reviewing and reporting on maternal deaths, not the Department of Health and Welfare, which formerly oversaw the committee. Blanksma voted against the establishment of the maternal mortality committee in 2019 and moved to hold Healey’s bill in committee last year. She did not respond to requests for comment from the Statesman on why she introduced the bill.

Huntsberger, who now practices in Oregon after moving from Sandpoint, said Blanksma’s bill leaves out elements crucial to the success of a maternal mortality review board. Huntsberger helped create the review committee and said in a phone interview that the 2019 legislation was carefully crafted to protect patient privacy and ensure committee members could not be called upon to disclose committee discussions.

Dr. Emily Corrigan, a Boise doctor who serves as Idaho section chair of the American College of Obstetricians and Gynecologists, told the Statesman she and other physicians are working with lawmakers to fine-tune Blanksma’s bill with the hope of creating those protections.

“We’re very excited that it’s still the beginning of the session and we already have a bill to work with,” Corrigan said. “Our goal is to get the committee reinstated, to make sure that it’s a properly functioning committee with the appropriate experts on it and that has the immunity protection so that they can do their work and have proper access to all the necessary records.”

It’s not yet clear how Blanksma’s bill will be received by her fellow legislators. The topic of a maternal mortality review board has been controversial in the Legislature, with the 2019 bill passing by a single vote.

Huntsberger said she’s found the opposition baffling, especially given Idaho’s growing number of pregnancy-related deaths in the years the committee reviewed them. Deaths rose from 19 deaths per 100,000 live births in 2018 to to 40 deaths per 100,000 live births in 2021, according to the committee.

“Who doesn’t care about what happens to pregnant patients? What political party is that?” Huntsberger said. “What group of people doesn’t care what happen to moms? It’s completely shocking to me, and I still don’t understand it.”

Committee work still crucial, advocates and CDC say

During its operation, the review committee identified the majority of pregnancy-related deaths in Idaho as preventable. It found the leading cause of pregnancy-related deaths between 2018 and 2021 was mental health conditions — though the committee’s final report, issued last summer, noted that a preliminary look at 2022 data showed a major shift in risk factors.

Corrigan said Idaho-specific data is key to helping health care providers serve their patients. She noted that pregnant patients in Idaho have different challenges from elsewhere in the United States due to the state’s vast rural areas, maternity care deserts and lack of access to emergency medical services.

Corrigan and Huntsberger also said the committee’s previous work, while valuable, offers only a snapshot of maternal health care issues. Over time, risk factors can shift, creating a moving target that can’t be addressed with just a few years of outdated analysis.

“It’s an ongoing thing and something that is a long-term issue,” Corrigan said. “Missing data from the past year will affect us in the years to come if we don’t have that information about why these (fatal) events occurred.”

Some information will still be available. The Idaho Department of Health and Welfare collects vital statistics on the deaths of people who died during or within one year of pregnancy; however, that data does not provide the same level of insight as a Maternal Mortality Review Committee’s analysis.

Dr. Stacy Seyb, a maternal fetal medicine specialist who served as the committee’s chair, said Health and Welfare’s vital statistics are taken from death certificates and contain bare-bones information on the deceased. The review committee assessed hospital records, police and autopsy reports, family interviews and more to understand health care decisions, socioeconomic factors, knowledge gaps and other circumstances around each pregnancy-related death.

The Centers for Disease Control and Prevention, which provides financial support for state maternal mortality committees, uses Health and Welfare’s basic vital statistics in its national Pregnancy Mortality Surveillance System. Pooja Gala, a spokesperson for the federal agency, told the Statesman in an email that its data collection “should not be affected” by the dissolution of Idaho’s committee.

Still, Gala said, state maternal mortality prevention infrastructure has a proven track record of making a difference in pregnancy-related deaths.

Gala said state-level maternal mortality review committees “have the potential to get the most detailed, complete data on maternal mortality and develop actionable recommendations for prevention based on the state context.” She said this spring the CDC will release grant money that could fund a committee in each state.

Huntsberger said despite guaranteed funding and Idaho politicians’ vocal commitment to families, she’s not convinced lawmakers will reinstate the committee — especially after the “shocking” rejection of last year’s legislation.

“The things that were true last year remain true now,” she said. “This is a really simple way for us to demonstrate that pregnant people matter to us, that families matter to us and we want to do things to keep them safe.

“Instead of politicians talking about being pro-life, show me,” Huntsberger said.

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