1. Freda, Margaret Comerford EdD, RN, CHES, FAAN

Article Content

We in perinatal nursing are fortunate to have many professional resources dedicated to the same goals that we have-helping women become healthier, and guiding women and infants through the continuum of childbearing. The March of Dimes has been one of the most foreward thinking in this regard. Although founded originally to cure the scourge of polio, the March of Dimes has continued through subsequent years to provide all of us with invaluable guidance about all aspects of maternal/child health. During the last several decades, the March of Dimes has also become an important "convenor," that is, they bring together all interested parties (physicians, nurses, regulators, professional organizations, governments, business leaders, researchers, and scholars) concerning a particular health issue, review and discuss the science and the evidence for our work, and then develop guidelines to help us meet goals and objectives. In the 1970s, in response to the rise in specialized NICU care and subsequent lower mortality for infants, the March of Dimes convened its first "Toward Improving the Outcome of Pregnancy" working group. Its final recommendations were that integrated systems based on acuity level would lead to lower mortality, and that regionalization of care should be the model adopted. Its seminal monograph Toward Improving the Outcome of Pregnancy (now known as "TIOP I") became the guiding principle throughout that decade and beyond.


In the 1990s they took the lead in encouraging stakeholders and providers to look beyond the 9 months of pregnancy, and to add preconception health to the areas of health concerns. Toward Improving the Outcome of Pregnancy II (TIOP II) was published in that decade.


Now, at the beginning of this new century, the March of Dimes has again convened the most knowledgeable professionals in the field to develop "TIOP III Toward Improving the Outcome of Pregnancy: Enhancing Perinatal Health Through Quality, Safety and Performance Initiatives." I'm very excited about this volume, for it is truly a roadmap to what perinatal providers should accomplish in order to provide comprehensive care in a safe and way.


What's in it for you? I'd suggest that each of you peruse this volume, and be sure that your organization is aware of it, for this is the document that will direct pregnancy care in the coming decade. You will learn so much!! Perhaps you're interested in expanding your institution's use of Family Centered Care, or maybe you have been asked to examine your hospital's methods for finding posptartum women experiencing postpartum depression. This TIOP III will tell you about existing programs that have been successful, thus increasing your chances of positive outcomes as well. This is the Quality Improvement document we have all been waiting for.


Although there are countless pearls of wisdom in this 13 chapter document, I want to point out the strong role of nursing and nurses in this TIOP III at all stages of development, writing, and completion. The Steering Committee had a large number of nurses (including representatives from many nursing organizations), as did the Advisory Committee. Each chapter has at least one nurse author, and many have more. Many of the chapters' lead authors are nurses, and many of the concepts presented (such as Family Centered Care, Centering Pregnancy, and Postpartum Depression screening) are topics long studied by nurses and considered our domain. I urge you to contact your local March of Dimes chapter and obtain TIOP III. I'm sure it will be useful to you and to your patients for many years to come.