Maternal mortality review legislation succeeds in Montana

Dr. William J. PetersWilliam J. Peters, MD, past District VIII chair and past Montana Section chair

On March 18, Montana Gov. Steve Bullock signed the Fetal, Infant, and Child Mortality Review Amendment Bill into law. The legislation, sponsored by State Rep. Liz Bangerter (R-Helena), passed the Montana House and Senate, allowing maternal mortality review to be provided in the state once again.

        Montana Section Bill Signing

Mark F. Garnaas, MD; Kathleen G. Nelson, MD, Montana Section chair; and William J. Peters, MD, past District VIII chair and past Montana Section chair, at the Montana State Capitol


This legislative success was the result of a Montana Section initiative to address the increasing rate of maternal mortality in the state and the lack of a maternal mortality review providing clinical correlation of Montana Department of Public Health and Human Services (DPHHS) maternal death data. The bill amends the already established Fetal, Infant, and Child Mortality Review (FICMR) Prevention Act (established in 1997), which had existing infrastructure (28 statewide review teams) and enabling legislation. The amendment bill was budget neutral and had the support of an overwhelmingly persistent ad hoc coalition.

The ad hoc coalition began with my position as regional chair of ob-gyn at the Billings Clinic. The amendment bill was supported by the clinic; addressed and supported by Kathleen G. Nelson, MD, Montana Section chair, and Tyler J. Bradford, MD, Montana Section vice chair; and followed by Susan M. Lemagie, MD, District VIII chair. It also had the approval of the District VIII Advisory Council.

Montana Section Bill Signing

Montana Gov. Steve Bullock signs the Fetal, Infant, and Child Mortality Review Amendment Bill into law, surrounded by members of the ad hoc coalition that supported its progress.




ACOG staff, particularly Kathryn Moore, director of state legislative and regulatory affairs, and Jeanne Mahoney, director of providers’ partnership, provided information and continued direction. The Billings Clinic, Bozeman Deaconess Hospital, and the Montana Medical Association (MMA) provided lobbyist support. Shaun Gillis, MD, incoming Montana Section vice chair and current MMA president, facilitated extra MMA legislative muscle to the coalition. 

Letters of support for the legislation came from the Montana Academy of Family Physicians, Montana Academy of Pediatrics, Montana Nurse Midwives, and Montana Medical Association. Montana DPHHS was present from the beginning with documentation of maternal death certificates and a statewide survey that demonstrated accurate reporting documentation of Montana maternal deaths.

Montana DPHHS has requested the Montana Section coordinate implementation of the FICMR Prevention Act amendment. One special review request is to provide a Montana Section ob-gyn if the occasional Montana FICMR team doesn’t have access to a local ob-gyn in rural Montana.

For more background on this bill and its process, read “Saving moms in Montana: A maternal mortality review initiative” in the December 2012 issue of the Gazette.

American Congress of Obstetricians and Gynecologists
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