Rachel Sinkey, M.D., Assistant Professor of UAB OB/GYN & Committee Chair of AL-MMRCThe Alabama Maternal Mortality Review Committee (AL-MMRC), housed within The Alabama Department of Public Health (ADPH), recently published their first Maternal Mortality Review Report from the newly-convened committee.

Approximately one-third of maternal deaths in Alabama happen during pregnancy, around one-third occur after delivery up to six weeks postpartum, and another third occur between 43 and 365 days after delivery.

The report states that over 700 maternal deaths transpire annually in the U.S., and, according to the Centers for Disease Control and Prevention (CDC), Black/African American women are three times more likely to die from a pregnancy-related cause than white women.

In its efforts to increase the health and well-being of all Alabama mothers, the ADPH launched the AL-MMRC in 2018. The committee, which includes multiple medical professionals from UAB, works to review maternal mortality in Alabama and propose solutions to reduce the number of maternal deaths.

When a woman dies, a pregnancy check box must be filled out on the death certificate to indicate whether the decedent was pregnant or up to one year postpartum. These documented deaths are reported to the ADPH Center for Vital Statistics where a list of maternal deaths is generated and sent to the AL-MMRC. The AL-MMRC then requests records, generates a case abstract, and reviews further.

Maternal mortality numbers include women who died while pregnant, during childbirth, or up to one year after delivery. However, the cause of death for these women may not always be due to pregnancy.

“Based on guidance from the CDC, a maternal death is classified as a pregnancy-related death or a pregnancy-associated death,” says Rachel Sinkey, M.D., assistant professor in the UAB Department of Obstetrics and Gynecology and committee chair of the AL-MMRC. “A pregnancy-related death occurs as a result of the pregnancy, while a pregnancy-associated death occurs to a pregnant or postpartum patient that was unrelated to the pregnancy. A motor vehicle accident is an example of a pregnancy-associated death.”

The process to review and report maternal mortality cases is extensive to ensure accuracy. In 2019, the AL-MMRC reviewed cases from 2016 and published their results in the fall of 2020.

The report provides a detailed outline of pregnancy-associated deaths in 2016. Key findings, data, and recommendations, among other vital information, can be found in the report. A supplemental infographic was also created to share a clear call to action.

Recently, a legislative resolution recognizing the AL-MMRC’s efforts and recommendations was submitted. The resolution specifically recognizes the AL-MMRC’s first Maternal Mortality Review Report and calls for continued funding.

“The committee is vital to understand why maternal deaths occur in our state,” Sinkey says. “I’m grateful for the AL-MMRC leadership including Dr. Grace Thomas, who manages the ever-growing team within the ADPH, to Dr. Susan Baker from the University of South Alabama, who serves as the vice chair and provides meticulous case reviews, and to Evelyn Coronado-Guillaumet, MPH, whose experience coordinating the Texas Maternal Mortality Review was instrumental in shaping the newly formed AL-MMRC.”

The AL-MMRC consists of many UAB medical professionals – all who bring a unique and important perspective to the review of each deceased mother. The committee meets four to six times annually to continue its work and produce future findings and materials.

AL-MMRC leadership from UAB include:

Rachel Sinkey, M.D., FACOG, Committee Chair | UAB Department of OB/GYN
Evelyn Coronado-Guillaumet, MPH, National Liaison | UAB School of Public Health

AL-MMRC members from UAB include:

Paul V. Benson, M.D. | UAB Department of Pathology
Marc G. Cribbs, M.D., FACOG | UAB Department of Medicine and UAB Department of Pediatrics
Blair Danielle Hedges, MSN, CRNP, M.A. | UAB Psychiatric-Mental Health Nurse
Pete Lane, D.O. | UAB Department of Psychiatry and Behavioral Neurobiology
Tiffani Maycock, D.O. | UAB Selma Family Medicine Residency
Megan Mileski, MSN, R.N. | 2020 Graduate of UAB’s Applications of Mixed Methods Research Program
Mark Powell, M.D. | UAB Department of Anesthesiology and Perioperative Medicine
Lindsay Speros Robbins, M.D., MPH | UAB Department of OB/GYN
Michelle Tubinis, M.D. | UAB Department of Anesthesiology and Perioperative Medicine
Jennifer Kendall, M.D. | Cahaba-UAB Family Medicine Residency Program
Lauren Linken, M.D. | Cahaba-UAB Family Medicine Residency Program