Patient Safety

Are We Doing Enough to Prevent Maternal Death? From the Desk of PPAHS’s Executive Director

Editor’s note: In this editorial from the desk of the Executive Director of the Physician-Patient Alliance for Health & Safety, Michael Wong, JD asks, “Are We Doing Enough to Prevent Maternal Death?”

By Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety

A US Crisis

The birth of a child is a time to celebrate. As Angela Johnson, a mother of two, writes:

The birth of a new baby is always cause to celebrate. In the United States, people go out of their way to shower new parents and the baby with food and gifts to show their delight at the arrival of a healthy new bundle of joy. But if you travel around the globe, you’ll discover that different cultures have unique ways of welcoming a new life into the world. If you’re looking to go beyond cupcakes and flowers, you may be interested to learn the ways people around the world celebrate the birth of a child.

@bkangiej - birth of a new #baby is always cause to celebrate #maternalhealth Click To Tweet

Unfortunately, the birth of child may not be always be surrounded by joy. As the Merck for Mothers website states:

Although maternal death rates have declined globally over the past 25 years, the U.S. is one of the only high-income countries where maternal mortality is on the rise.

@MerckforMothers: US is one of the only high-income countries where #maternalmortality is on the rise Click To Tweet

According to the CDC, the maternal death rate in the U.S. has more than doubled since 1987.

CDC Maternal death rates

William M. Callaghan, M.D., M.P.H. (senior scientist for the maternal and infant health branch in CDC’s Division of Reproductive Health at the National Center for Chronic Disease Prevention and Health Promotion) told me that this trend may actually be under-reported:

“These statistics may represent a conservative estimate of the problem. Why? Not all pregnancy-related deaths are accurately identified and reported. Hence, pregnancy-related deaths identified at the national level likely undercount the true number.”

Moreover, a recent USA Today investigation found:

Each year, about 50,000 U.S. women are severely harmed and about 700 die because of complications related to childbirth. African-American moms are three to four times more likely than white moms to die or suffer devastating childbirth injuries

@USATODAY: Mothers are dying #maternalmortality #maternalhealth Click To Tweet

Are We Doing Enough to Prevent Maternal Death?

In the face of these frightening statistics, we need to ask ourselves – “Are We Doing Enough to Prevent Maternal Death?”

The Physician-Patient Alliance for Health & Safety responded to this question five years ago by releasing the OB VTE Safety Recommendations. These recommendations were released with the Institute for Healthcare Improvement and the National Perinatal Association.

These recommendations address a critical patient issue, according to Frank Federico, RPh  (then Executive Director at the Institute for Healthcare Improvement and Patient Safety Advisory Group at The Joint Commission).

According to Mr. Federico, “These recommendations focus on prevention measures that can easily be adopted and used by healthcare facilities to prevent VTE and help ensure that delivering mothers go home safely with their babies.”

The health and well-being of mothers and infants is central to the efforts of the National Perinatal Association. MaryAnne Laffin, NP, CNM, FACNM (Immediate Past President, National Perinatal Association) says that pregnant mothers need to understand the added risk of VTE that pregnancy and delivery by cesarean section brings. In addition, they need to be aware of this risk not only antepartum or prior to delivery, but that this risk continues upon discharge and up to one month post partum.

“The risks of VTE are 4-5 times higher for pregnant women than for non-pregnant women,” says Ms. Laffin. “Women not only need to know of the added risk of blood clots during pregnancy, but that this risk increases following cesarean birth. Following c-section, the risk of VTE is almost two times higher. For the safety of pregnant women, the National Perinatal Association therefore encourages all hospitals to adopt these VTE safety recommendations.”

The OB VTE Safety Recommendations were developed with the advice and counsel of a panel of experts brought together by the Physician-Patient Alliance for Health & Safety. They provide four concise steps that:

  • Assess patients for VTE risk with an easy to use automated scoring system
  • Provide the recommended prophylaxis regimen, depending on whether the mother is antepartum or postpartum.
  • Reassesses the patient every 24 hours or upon the occurrence of a significant event, like surgery.
  • Ensures that the mother is provided appropriate VTE prevention education upon hospital discharge.

For a copy of the OB VTE Safety Recommendations, please click here.

Use the OB VTE Safety Recommendations and Save a Mother’s Life #maternalmortality #maternalhealth Click To Tweet

Recently, a bill was passed aimed at reducing the United States’ maternal mortality rate. In commenting on this bill, USA Today said:

the bill passed last week by both houses of Congress does not specifically require states to examine whether flawed medical care played a role.

Studies have found that at least half of childbirth-related deaths could have been prevented if health care providers had followed best medical practices to ensure complications were diagnosed and treated quickly and effectively.

We clearly need to do more to prevent further maternal deaths.

We need to do more to prevent further maternal deaths #maternalmortality #maternalhealth Click To Tweet

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