1. Callister, Lynn Clark PhD, RN, FAAN

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Maternal mortality in the United States has increased rather than decreased in recent years, which is of serious concern (MacDorman, Declercq, Cabral, & Morton, 2016). A creative ongoing initiative may be helpful in highlighting this important issue by raising public awareness of the tragedy of maternal deaths. A nonprofit organization, the Safe Motherhood Quilt Project, was generated to honor women who lost their lives over the past 35 years (since 1982) as a result of pregnancy-related causes ( These deaths are documented by an obituary, death certificate, or a relative or witnesses account. According to the Web site, "the quilt is a voice for women who can no longer speak for themselves." The quilt squares include some of the following women:


* Christine Bolden was 26 years old when she passed away in 2012 following suffering a cerebral aneurysm. She was kept on a respiratory for a month to save her twin sons Nicholas and Alexander. This mother had two other children.


* Carlene Mossman was 40 years old when she had an amniotic fluid embolism during the birth of her seventh child.


* Ama Thomas had a missed abortion at 20 months gestation, resulting in disseminated intravascular coagulation with fatal complications. She had four other children.


* Angela Wilburn was 28 years old when she was pregnant with her eighth and ninth children. Her labor was induced and she gave birth vaginally to her son Rodney but when the second son's umbilical cord prolapsed, she had a cesarean birth. She bled profusely, resulting in having a hysterectomy. Because she was a Jehovah's Witness, she refused a blood transfusion and subsequently passed away.


* Cindy Wilson, 37 years old sergeant in the United States Air Force, died in 2007 12 hours after having a cesarean birth, during which a uterine artery was severed, causing massive internal bleeding. Her newborn daughter survived.


* Becky Zaleswki, 38 years old, died in 2007 with her obituary noting that she died as a result of a stroke just after giving birth. Her son survived.



The quilt has more than 200 uniquely designed blocks in over 10 panels. The quilt pieces are 16 in. horizontally by 12 in. vertically, with a margin of at least 1 in. on all sides. Quilt squares can be submitted to The Safe Motherhood Quilt Project, 2276 Clematis Street, Sarasota, FL 34239. The following should be enclosed in order for the pieces to be considered to be part of the quilt: a newspaper obituary, copy of death certificate, and/or relative or friend's written account. Volunteers will help create quilt pieces for those who would like to participate.


These panels have been exhibited in the United States and globally at hospitals, clinics, conferences, libraries, and special events. A virtual quilt is being generated so that these women can be honored and remembered.


The Confidential Enquiry into Maternal Deaths (CEMD) in the United Kingdom (UK) is an initiative, which analyzes all maternal deaths implemented in 1952. This initiative has resulted in multiple publications such as one documenting perinatal outcomes among migrant mothers in the UK (Puthussery, 2016). Maternal mortality rates have dropped from 90 per 100,000 women giving birth in 1952 to 10 per 1000,000 in 2014 (


In the United States, the use of predictive models is proposed in an effort to reduce maternal morbidity and mortality (Levinson, Miranda, & Rojas-Suarez, 2017). A powerful combination of the provision of artistic efforts such as the Safe Motherhood Quilt Project honoring the lives of mothers lost, and use of initiatives such as the CEMD and prognostic models in childbearing women that predict maternal mortality are essential.




Levinson A., Miranda J., Rojas-Suarez J. A. (2017). Predictors of maternal mortality and prognostic models in obstetric patients. Seminars in Respiratory and Critical Care Medicine, 38(2), 191-200. doi:10.1055/s-0037-1602244 [Context Link]


MacDorman M. F., Declercq E., Cabral H., Morton C. (2016). Recent increases in the U.S. maternal mortality rate: Disentangling trends from measurement issues. Obstetrics and Gynecology, 128(3), 447-455. doi:10.1097/AOG.0000000000001556 [Context Link]


Puthussery S. (2016). Perinatal outcomes among migrant mothers in the United Kingdom. Best Practice and Research Clinical Obstetrics and Gynecology, 32, 39-49. doi:10.1016/j.bpobgyn.2015.09.003 [Context Link]