In 2025, a Fort Walton Beach woman died after developing severe pregnancy complications, leaving her firefighter husband to raise their baby girl on his own. 

An elite Olympic athlete – once the fastest woman in the world – was found dead at her home in Orange County in 2023, eight months pregnant.

A Panama City mom died by suicide two months after giving birth to her second child in 2024, after suffering from postpartum depression.

Cases like these are why Florida’s Maternal Mortality Review Committee was created two decades ago: to investigate why Florida moms are dying during and after pregnancy – and to stop preventable deaths from happening in the first place.

But the secretive panel housed within the Florida Department of Health hadn’t publicly released any annual findings in years until a Florida Trib reporter asked agency officials last week about the committee’s apparent lack of action. That years-long blackout covered a time during which critics have accused Gov. Ron DeSantis and his surgeon general who oversees FDOH, Joseph Ladapo, of politicizing public health, and when the state enacted a near-total abortion ban – which researchers have found has led to increased maternal deaths in other states with similar laws.

After the Florida Trib asked FDOH last week about the lack of updates from the committee since its analysis of 2020 maternal deaths, agency officials quietly uploaded reports for deaths that occurred in 2021, 2022 and 2023 to the FDOH website, though the analyses and recommendations are significantly more narrow compared to reports from previous years.

The state refused to release the names of Maternal Mortality Review Committee members, which in other states are published routinely. Florida law generally requires deliberative bodies to operate in public, but the maternal health committee operates almost entirely outside the public eye, except for the annual reports. 

Its meetings are not noticed, and there are no published agendas or meeting minutes. It’s also not clear who appoints the committee members or whether they are required to possess a medical degree or other relevant credentials.

“I can’t imagine what would enable them to keep it secret, but it’s on them to point to the law,” said David Cuillier, director of the Freedom of Information Project at the University of Florida’s Brechner Center for the Advancement of the First Amendment.

State officials didn’t respond to Florida Trib requests for more information about the committee, including its membership.

Multiple past advisory opinions from the Office of the Attorney General have concluded that advisory committees – particularly ones that make recommendations, like the Maternal Mortality Review Committee – are generally subject to Florida’s Sunshine Law.

The committee’s secrecy and delayed work product could have substantial cost, according to Melanie-Angela Neuilly, a professor at Washington State University who has researched maternal mortality review committees across the country.

“I think very straightforwardly, the impact is going to be lost lives,” said Neuilly, who studies public health and mortality statistics. 

“In order to understand how to better prevent death, we need to have information about those deaths,” she added.

How abortion restrictions have affected maternal health

Public health experts have warned that abortion restrictions are associated with worse maternal health outcomes, in part because data shows that continuing a pregnancy carries a greater risk of death than having an abortion.

Researchers have found documented increases in maternal deaths – and infant deaths – in Texas, after that state banned abortion in 2021. Across the country, state-level abortion restrictions are associated with parallel increases in maternal deaths from all causes, including violence. Homicide is now a leading cause of death for pregnant and postpartum women in the U.S.

Asked if Florida’s MMRC is assessing how the state’s 15-week and subsequent six-week abortion bans may have affected the state’s maternal mortality rates, FDOH spokesperson Brian Wright said it’s not the panel’s responsibility to find out. 

“Policy implications are not in the purview of this committee,” Wright said.

The recently released reports do not mention the state’s new limitations on abortion access.

Neuilly, the Washington State University professor, disputed Wright’s assertion, saying there is no public health response without policy. Neuilly recently coauthored a paper on the status of maternal mortality review committees in the wake of the U.S. Supreme Court decision eliminating the constitutional right to abortion, in a case known as Dobbs.

“As a scholar, I see this answer as naive. If not straightforwardly political,” Neuilly said. 

“In practical terms, it is about policy,” she added. “It is about changing the way practices operate so that we can make pregnancy safer.”

Florida’s most recent report found the state had a pregnancy-related mortality ratio of about 18.5 deaths per 100,000 live births, slightly below the national rate, and well below the recent high seen in 2021, when maternal deaths rose dramatically across the country. The results show Florida has persistent racial and ethnic disparities, with mortality rates for Black women spiking in 2023, the year a federal judge found Florida officials began illegally ending Medicaid coverage for hundreds of thousands of Floridians, including many pregnant and postpartum women.

Staci Tanouye, an OB-GYN in private practice in Jacksonville, expects maternal health outcomes to worsen in Florida due to the restrictions on reproductive health care – a fear that’s shared by her patients.

“Women in Florida are very scared right now,” she said. “They’re absolutely terrified.”

New documents released after the Florida Trib started reporting

All 50 states, Washington, D.C. and Puerto Rico have an interdisciplinary panel of medical experts tasked with investigating deaths that occur during and after pregnancy and developing clinical and public health recommendations, with some committees operating for nearly 100 years. 

It’s an acknowledgment that maternal health is a crucial indicator of the nation’s health – and it’s an effort to try to reverse the long-running and systemic failures that have left the U.S. with the worst maternal mortality rates among high-income countries, with stark disparities among racial and ethnic groups. According to the Commonwealth Fund, maternal death rates in the U.S. are triple that of Sweden, Japan, the Netherlands, Germany, the United Kingdom and France.

Florida’s maternal health disparities are stark: according to a multi-year analysis of MMRC data, Black women in Florida are more than twice as likely to die as non-Hispanic white women, and more than 10 times as likely to die as Hispanic women. Low-income women on Medicaid are twice as likely to die as moms on private insurance in Florida. Mothers who are obese or over the age of 35 also face substantially higher risk. That’s even as more than 80% of pregnancy-related deaths are preventable, according to the Centers for Disease Control and Prevention.

When the Florida Trib contacted the FDOH in March, the last annual report issued by Florida’s Maternal Mortality Review Committee was for deaths that occurred in 2020, an analysis that wasn’t published until 2022. 

That meant the panel had not publicly released any reports on the continued impact of the coronavirus pandemic in 2021 – when maternal deaths spiked nationwide – nor published any analyses of how maternal health outcomes have changed since the Dobbs decision, which opened the door for Florida to implement a 15-week ban in 2022, which was tightened to a six-week ban in 2024.

A spokesperson for FDOH told the Florida Trib that the MMRC is still actively meeting and reviewing cases, but would not say why the committee hadn’t publicly released any findings in recent years. A request for public records related to the committee is pending with the department. 

Then this month, FDOH quietly published the reports. The department spokesperson did not respond to questions about why the analyses had been delayed and why they’re being released now, or requests for the committee’s membership roster. 

“I cannot fathom what the exemption would be,” under the state’s open government law, said Catherine Cameron, a media law professor at the Stetson University College of Law. “This just sounds like obfuscation.”

Florida stands in contrast to other states, which readily release the membership of their panels, produce annual reports for state lawmakers as required by state law and hold public meetings for stakeholders to attend. 

The Florida Trib attempted to contact every person listed as a member of the committee in 2021, the last year public health officials published the membership roster. None agreed to speak on the record.

A ‘sentinel indicator’ for public health

Public health experts have long looked at maternal and child health outcomes as a way to assess public health more broadly.

“Infant mortality and maternal mortality are two sentinel indicators for the health of a community, in particular identifying critical disparities that exist in health outcomes,” said Jeffrey Goldhagen, a professor at the University of Florida College of Medicine who previously led the Duval County Health Department, and stated that his views are his own.

Maternal Mortality Review Committees are designed to go far beyond the collection of birth and death certificates, conducting at-times granular reviews of the complex factors that contribute to a maternal death.

A panel of doctors, nurses, midwives, social workers and statisticians review extensive case histories of patients who have died, though the records have been de-identified to protect their privacy. 

The reviews can include medical records, hospital charts and social service reports, as well as interviews with family members and loved ones, in an attempt to understand what contributed to the death, and to ultimately to answer the question: if she wasn’t pregnant, would she have died?

The committees are not intended to be prosecutorial or to assign individual blame, but instead to identify broad causes and systemic challenges that are driving maternal mortality – and develop recommendations to reverse those trends. 

Some of the Florida committee’s past recommendations have been quite revealing, questioning current policies and practices and proposing changes. 

“Systems need to explore the need to keep critically ill incarcerated women in shackles when in the hospital,” reads one recommendation from the analysis of 2019 deaths.

“Health care options for high-risk women, undocumented women, and uninsured women should be implemented,” reads another.

According to the recently released reports, in 2023, the leading causes of Florida’s pregnancy-related deaths – those directly attributed to pregnancy or childbirth – included hemorrhage, hypertensive disorder, embolism or blockage of a blood vessel, and cardiomyopathy. Most of Florida’s pregnancy-related deaths – 77% in 2020 – occur after the baby is delivered, either while the mother is still hospitalized or after they’ve been discharged. 

The findings and recommendations of Florida’s panel have been used to develop coordinated initiatives at hospitals across the state to educate clinicians on the risks of hypertension and obstetric hemorrhage, and to draw attention to the significantly increasing use of opioids during pregnancy. 

According to the MMRC, drug-related deaths have spiked in recent years. As of 2020, overdoses were the leading cause of pregnancy-associated deaths in Florida – that is, deaths of any kind that occur during pregnancy or up to one year postpartum. At that time, the rate of drug-related deaths was higher than the overall mortality rate for all pregnancy complications.

MMRC reports released in past years included a more detailed analysis of deaths that were deemed not-pregnancy related, including those due to suicides, homicides, drug use and car crashes. 

Those more detailed findings are noticeably absent from the three reports published to the FDOH website this month. That’s despite the fact that those deaths far outnumber the deaths directly related to pregnancy complications. 

A pattern of interference

In the wake of the Supreme Court’s Dobbs decision, advocates have said it’s imperative to strengthen maternal mortality review committees, as a critical tool to improve maternal health outcomes. But researchers have found some panels are falling victim to political interference, particularly in states that have restricted abortion. 

In 2023, Idaho became the first state to disband its MMRC, after the panel found that patients covered by Medicaid were overrepresented in maternal death rates and recommended that the state expand postpartum Medicaid coverage. The state reconstituted its committee in 2024.

In Texas, officials have prohibited that state’s committee from reviewing deaths that are deemed abortion-related, after ProPublica exposed two preventable deaths due to delays in care linked to the state’s abortion ban.

Neuilly, the WSU professor, said the fact that Florida’s committee isn’t codified in state law and doesn’t have reporting requirements is “a red flag” – rendering it less effective and more vulnerable to outside influence. 

“We’re seeing these trends throughout the country that are either limiting the powers of the maternal mortality review committees, or disbanding them altogether, replacing them with a different type of committee,” she added.

Goldhagen said the withholding of the MMRC’s findings in recent years is consistent with what he says is the DeSantis’ administration track record of using public health for political purposes – pointing to the surgeon general’s opposition to vaccines and a lack of public information about the state’s ongoing measles outbreak.

“It’s not an isolated instance,” Goldhagen said. “It’s a pattern of violation of public health ethics and principles that are being perpetrated for political reasons.”

Kate Payne is The Florida Trib’s state government reporter. She can be reached at kate.payne@floridatrib.org.