On March 4, 2026, the Policy Center for Maternal Mental Health submitted a formal letter to the Centers for Disease Control and Prevention expressing strong support for the continued investment and refinement of the Maternal Mortality Review Information Application (MMRIA).

MMRIA is a cornerstone of maternal health surveillance in the United States. It serves as the only standardized platform for Maternal Mortality Review Committees (MMRCs) to track and aggregate data, providing the clinical depth necessary to understand why maternal deaths occur and how they can be prevented. Most critically, MMRIA data has identified suicide and overdose as leading causes of maternal mortality, providing insights that other surveillance systems simply cannot capture.

Below is our full letter outlining why supporting the CDC’s request for revised burden hours is a necessary step toward targeted quality improvement and ultimately, saving the lives of mothers. This revision is necessary because the CDC has transitioned from using indirect estimates to capture actual case counts from 52 jurisdictions, a shift that, while increasing the reported administrative time, drastically improves the accuracy and clinical depth of our national maternal mortality data.

See the full letter below.

___________________________________________________________________________

March 3, 2026

Submitted electronically via regulations.gov

Jeffrey M. Zirger, PhD
Acting Deputy Director, Office of Public Health Ethics and Regulations
Information Collection Review Office
Centers for Disease Control and Prevention
Department of Health and Human Services
1600 Clifton Road NE, MS H21-8
Atlanta, Georgia 30329

Re: The Maternal Mortality Review Information App (MMRIA) (OMB Control No. 0920-1294, Exp. 5/31/2026)—Revision—National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC); Docket No. CDC-2026-0005

Dear Dr. Zirger:

My name is Joy Burkhard, and I am the Executive Director of the Policy Center for Maternal Mental Health, a 501(c) (3) nonprofit think tank facilitating programmatic and policy change. 

I am responding to the request for comment regarding the Centers for Disease Control and Prevention’s (CDC) Maternal Mortality Review Information Application (MMRIA) program. To ensure the national maternal mortality surveillance remains accurate and actionable, we support the CDC’s request for the Office of Management and Budget (OMB) to approve the revised estimate of 41,789 annual burden hours reflecting the additional 24 minutes on average needed to enter maternal mortality review committee (MMRC) decisions into the MMRIA platform. The change is a direct result of improved data integrity: the CDC has transitioned from using indirect estimates to actual case counts from 52 funded jurisdictions, reflecting the increased case counts. 

The CDC developed the Maternal Mortality Review Information Application (MMRIA or “Maria”) to standardize data collection and analysis for maternal mortality review committees (MMRCs). MMRIA provides the only standardized means to track and aggregate MMRC data across states, creating reliable state-by-state comparisons and a national picture of maternal mortality. 

Using standardized data gathered through MMRIA, the CDC was able to identify suicide and overdose as the leading causes of maternal mortality. MMRC data are the only national source that provides detailed information on mental health-related pregnancy-related deaths, which the Pregnancy Mortality Surveillance System (PMSS) does not provide. MMRC data also provides an assessment of preventability.  

This data has helped public-private organizations, including payors, providers, philanthropy, and others, identify targeted quality-improvement actions and areas to invest in. Absent this data, efforts and investments would be haphazard, and maternal mortality would likely increase.

Further, long-standing maternal death review systems in other high-income countries reinforce the value of this approach. The United Kingdom’s MBRRACE-UK programme, France’s National Confidential Enquiry into Maternal Death, and Australian Maternal Mortality surveillance, for example. 

Maternal Mortality is an indicator of the health of a nation and the functionality of a country’s healthcare system.

We urge you to continue to prioritize the MMRIA system and support the CDC’s request that OMB approve the additional estimated 41,789 annual burden hours. 

Please feel free to contact me at [email protected] with any questions or requests for additional information.

Respectfully submitted,

Sincerely,

Joy Burkhard, MBA
Executive Director