1. Begley, Robyn DNP, RN, NEA-BC

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As a former OB/GYN nurse, the work of protecting the health of mothers and infants resonates deeply for me. I have experienced the joy and sometimes heartbreak of labor and delivery. Years ago, I had only 4 months on an OB/GYN unit under my belt when one of my patients, who had given birth to twins and had normal postpartum vital signs, died of an amniotic fluid embolism. I can still see the father in the nursery, rocking his 2 babies, weeping.

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Unfortunately, national data show that US maternal deaths have doubled in the last 30 years, with 700 such deaths occurring annually.1 To reverse this trend, the American Hospital Association (AHA) has made improving material health part of its strategic plan and in 2018 launched Better Health for Mothers and Babies. This initiative has the goal of eliminating maternal mortality and reducing morbidity related to childbirth and delineates a 4-part action plan to help health system leaders and clinicians improve outcomes. The plan includes the following:


* Evaluate and act on data. Careful review of data will allow hospitals and clinics to target interventions on the conditions leading to morbidity and mortality.


* Examine and eliminate disparities. This practice allows clinicians to address unconscious and implicit biases that may be affecting care delivery.


* Engage mothers and their families. Using advisory groups and embracing a team-based approach can encourage women to take an active role in their care.


* Partner with community stakeholders. Many complications occur outside of the hospital stay for labor and delivery. Finding partners to provide support and resources for mothers before, during, and after delivery will encourage the best health for mothers and infants.



In my role as AHA chief nursing officer, I have championed this cause and am pleased to see the number of organizations that have passionately stepped up to the challenge of fighting morbidity and mortality for mothers and infants. The AHA's Better Health for Mothers and Babies webpage showcases the work of these organizations, many led by nurses, using new approaches that demonstrate positive patient outcomes.


For example, Philadelphia-based Penn Medicine implemented its Heart Safe Motherhood program to improve outcomes of postpartum women in the days following their discharge. Mothers with high blood pressure (B/P) received education on how to take B/P readings at home and were able to send their results to Penn clinicians with the help of a mobile app and twice-daily text reminders to take the readings. This has enabled the care team to safely adjust participants' B/P medications and decrease postpartum hypertension readmissions.


Another case study highlights Titus Regional Medical Center in Mount Pleasant, Texas. The medical center uses a protocol in which staff conduct a vital indicator and bleeding assessment every 15 minutes in the 1st 2 hours after delivery. In addition to the assessment, the hospital uses a worksheet listing the dry weight measures for items such as sheets or pads, allowing clinicians to quantify the blood loss for a patient. Since putting these and other measures in place, morbidity due to blood loss has fallen.


To learn more about these case studies and read others, please visit I encourage nurse leaders to submit their organization's innovations for improving maternal and infant care to the AHA via the website or email it to The AHA remains committed to working to eliminate maternal mortality and reduce morbidity related to childbirth. With your help, we can continue to spread innovative practices that will lead to healthier mothers and babies.




1. Pregnancy Mortality Surveillance System. Accessed February, 19, 2020. [Context Link]