The Centers for Disease Control and Prevention has spent years building a nationwide system to study maternal deaths, identify preventable causes and recommend ways to keep similar deaths from happening again.
It has goals. It has performance measures. It has federal funding. It even commissioned a formal plan to evaluate whether the program is producing broader changes in public health, policy and services.
What it does not yet have is funding to carry out that evaluation.
That detail appears near the end of a new Government Accountability Office report examining Maternal Mortality Review Committees, or MMRCs, and the CDC program that supports them.
The underlying problem is substantial. GAO reports that more than 600 women die each year during pregnancy or from causes aggravated by pregnancy in the United States. According to CDC, more than 80 percent of those deaths are preventable. GAO also notes persistent racial and ethnic disparities, with Black and American Indian/Alaska Native women experiencing maternal deaths at rates at least 2.5 times that of White women.
MMRCs are intended to help explain why these deaths happen. The multidisciplinary state and local committees review deaths occurring during pregnancy or within a year after pregnancy, examining medical records, death certificates, social-service records and, where available, autopsy reports and interviews with family members or other close contacts.
The committees determine causes, assess whether deaths were pregnancy-related and preventable, identify contributing factors and recommend actions intended to prevent similar deaths.
A Growing Federal Investment
Since 2019, CDC has supported the committees through its Enhancing Reviews and Surveillance to Eliminate Maternal Mortality program, better known as ERASE MM.
According to GAO, CDC provided approximately $65 million to 46 recipients during the program’s first five-year funding cycle, from 2019 through 2024. For the second cycle, covering 2024 through 2029, CDC plans to provide approximately $134 million to 52 recipients.
GAO’s review generally gives CDC credit for establishing an oversight structure around that money. The agency has four long-term goals, five near-term goals and 15 performance measures. Eleven of those measures have specific quantitative targets and time frames.
CDC also collects progress reports, reviews performance data, meets regularly with committees and conducts site visits. Agency officials annually review performance measures for individual MMRCs and use the information for planning and technical assistance.
In other words, this is not a case in which the federal government created a program, wrote a check and wandered away.
But measuring whether committees are performing their assigned tasks is not quite the same thing as determining whether the overall program is producing the intended results.
The Evaluation Waiting on the Shelf
To examine the broader question, CDC contracted with an external evaluator to develop an evaluation plan for ERASE MM.
That plan was completed in 2024.
According to GAO, the evaluation is intended to determine how the program has contributed to changes in awareness of maternal mortality prevention recommendations, public-health capacity, and policies, programs and services affecting maternal health outcomes.
As of July 1, 2026, however, CDC had not allocated funding to implement it.
CDC officials told GAO that the evaluation plan requires additional revisions and refinement to align with administration priorities. The agency would also need to explore the availability of funding before implementing it.
So the evaluation plan exists. The evaluation does not.
Another Measurement Problem
GAO identified another limitation that makes the missing broader evaluation more noteworthy.
Nine of the 10 MMRCs interviewed by GAO said they found it difficult to track performance measures involving implementation of their recommendations. One committee explained that publicly available information can make it difficult to determine whether a recommendation was implemented, when implementation occurred or who carried it out.
CDC told GAO it is aware of that problem and provides technical assistance and tools to help committees share and track recommendations.
The distinction is important. The report does not conclude that ERASE MM is ineffective, nor does GAO recommend that CDC overhaul the program. In fact, GAO found that CDC has incorporated key federal performance-management practices into its oversight.
What the report does reveal is a gap between monitoring the machinery and conducting the broader evaluation designed to determine what that machinery is accomplishing.
The Stakes Behind the Metrics
GAO’s state-level data illustrate why that distinction matters.
Using CDC mortality data from 2018 through 2024, GAO counted 5,613 maternal deaths nationwide, for a rate of 21.8 deaths per 100,000 live births. The rates varied sharply among states. Tennessee recorded 37.3 deaths per 100,000 live births, Louisiana 36.4 and Mississippi 35.6. California’s rate was 11.0.
GAO cautions that those figures use CDC’s narrower definition of a maternal death, generally covering pregnancy through 42 days after termination of pregnancy, and therefore do not include every pregnancy-related death that MMRCs examine.
The federal government has established committees, collected data, developed recommendations, created performance measures and committed roughly $134 million to the current five-year funding cycle.
It has also developed a plan for answering the next logical question: What difference is the program making?
For now, according to GAO, funding the effort to answer that question remains another item on the government’s to-do list.
