The Council on Patient Safety in Women's Health Care (2017) is a coalition of professional organizations working to collectively promote safe maternity care for all women through maternal patient safety research, programs and tools, education, dissemination, and promotion of a culture of respect transparency and accountability (http://safehealthcareforeverywoman.org/about-us/). Council members include the Association of Women's Health, Obstetric, and Neonatal Nurses, the American College of Nurse-Midwives, the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, and the Society for Maternal-Fetal Medicine among others. Expert clinicians and researchers, including nurses, from council member organizations have collaborated to develop patient safety bundles on a number of issues vital to safe maternity care for mothers and babies. Bundle topics include obstetric hemorrhage, severe hypertension in pregnancy, maternal mental health (depression and anxiety), reduction in peripartum racial and ethnic disparities, care for women with opioid use disorder, safe prevention of primary cesarean birth, maternal venous thromboembolism, severe maternal morbidity review, postpartum care, and support after a severe maternal event (http://safehealthcareforeverywoman.org/patient-safety-bundles/). The content is organized within the framework of readiness, recognition and prevention, response, and reporting systems/learning. Each aspect of the framework includes key points for every woman, provider, and birthing facility as applicable. References to supportive evidence are likewise organized in this framework (Council on Patient Safety in Women's Health Care).

There are abundant evidence-based resources available at no charge from the council (http://safehealthcareforeverywoman.org/aim-program/about-aim/) and from other organizations. Nurses and other members of the multidisciplinary team that provide maternity care should be familiar with these bundles, tools, and references. If the bundles are not known to clinical and organizational leaders, bring them forward in unit or department meetings after thorough review and preparation on the opportunities for enhancing maternity care. Gather support from fellow maternity team members. Consider adopting one of the maternity patient safety bundles as a first effort and move forward with others as success is achieved. Consider encouraging and leading your birthing facility into participation in a perinatal quality care collaborative (PQCC). The Centers for Disease Control and Prevention (CDC), is supporting PQCCs in many states. See if your state is a participant (https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pqc.htm). The CDC offers a resource guide on how to develop and sustain a PQCC (https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pdf/Best-Practices-f). Many healthcare systems have developed PQCCs. Make sure your birthing facility is an active member. The California Maternal Quality Care Collaborative has multiple well-developed tool kits for maternal patient safety as well (https://www.cmqcc.org/resources-tool-kits/toolkits) including topics such as obstetric hemorrhage, promoting vaginal birth and reducing primary cesareans, preeclampsia, and elimination of nonmedically indicated births before 39 weeks gestation. They describe current evidence and suggest strategies for promoting best practices on each topic.

Mothers and babies can benefit from standardized clinical protocols for the most common maternity care situations. When everyone has reviewed the evidence, practiced using drills, knows the step-by-step plan in an emergent situation, and works as a team in a culture of safety with mutual respect and collaboration, there is the best chance for healthy outcomes. Many aspects of maternal morbidity and mortality are preventable (Council on Patient Safety in Women's Health Care, 2017). Standardized clinical protocols for maternity care may offer an opportunity to reduce risk of preventable harm.

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