A July 2018 USA Today investigation into the state of obstetric and maternal care in the United States didn’t pull any punches. It called this country “the most dangerous place to give birth in the developed world,” going on to say that every year more than 50,000 U.S. mothers are severely injured during or after childbirth, and 700 fail to survive giving birth.
Why? Because, the report charges, hospitals are not following safety measures that could prevent or lessen common pre-delivery and delivery issues. Speaking to CBS This Morning, USA Today investigative reporter Alison Young said, “Experts say that about 50 percent of the deaths of women from childbirth-related causes could be prevented if they were given better medical care, and that's a really surprising thing given that we're one of the wealthiest countries in the world and we spend so much on medical care. We're not just talking about the women who die, we're talking about 50,000 U.S. women who are suffering life-altering harms.”
During the CBS interview, one of many that followed publication of the explosive report, Young added that the two leading causes of childbirth deaths and injuries are hemorrhage and severe hypertension, both of which can be guarded against by careful scrutiny of a patient's blood pressure and blood-loss levels. The investigation found that medical professionals often only estimate how much blood a woman loses during childbirth instead of measuring it for warning signs that something's not right.
AHA speaks out and promises aggressive response
The medical community wasted no time in responding to the USA Today coverage. The American Hospital Association’s Jay Bhatt, D.O., senior vice president and chief medical officer, wrote an op-ed in response that acknowledged the issue, and then addressed paths for increased safety going forward. He also pointed out non-facility related issues that are significant to the problem, such as:
These inhibitors to successful outcomes can affect maternal health throughout pregnancy, not just at delivery. Even so, Bhatt said, “One preventable complication is one too many. That is why hospitals across the country have led national improvement projects—to test new ideas and disseminate practices that improve care for all.” He then pointed out that collaboration already occurs in the healthcare industry, which is a positive: “It’s important to note that federal quality data cited by USA Today in its article on maternal mortality is a result of ongoing, voluntary efforts to help share best practices and improve care across the field.”
Staggering as these charges might be, the investigation also shone a clear light on a solution that’s always been one of the healthcare community’s greatest strengths: the collection of evidence-based best practices and rigorous training around them. As an example, the piece called out California, where the California Maternal Quality Care Collaborative was founded in 2006, and where hospitals have partnered with safety advocates such as the Alliance for Innovation on Maternal Health (AIM), to set into place practices that lowered the state’s maternal death rates by 55 percent from 2006 to 2013.
Those complication-reduction efforts will be multifaceted and involve everything from retraining to ensure staff competency to data collection and review to see where problems are occurring, as well as focusing on the groups of maternal patients most affected so that customized solutions can be crafted. A comprehensive approach such as that is provided in HealthStream’s Obstetrics (OB) Risk Program, a risk-focused leaning series that includes:
Access to an OB-specific control center, a data visualization and benchmark portal, is one proven method of guaranteeing not only staff education focused on reducing risk and creating more positive outcomes. It also gathers data for future study and an ongoing awareness and prevention campaign.
For information on HealthStream’s OB Risk Program, click here.
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