A new report from the Centers for Disease Control and Prevention (CDC) shows that maternal mortality rates in the United States continue to rise. Deaths of women during and after pregnancy have been steadily increasing over the past few years and Black women continue to be the most affected.
“The report covers data through 2021 so there were significant increases that could be attributed to severe illness from COVID-19,” said Mark Simon, OBHG Chief Medical Officer. “It also highlighted increases in disparities in care, maternal age and chronic pregnancy conditions such as hypertension. There isn’t one clear factor that is driving the increase, there are multiple causes. However, as an OB hospitalist organization, we are taking action to improve maternal healthcare in our country. Our OB hospitalists have a unique opportunity to make a difference and it is crucial that our teams continue to identify areas of opportunity and improvement.”
“The continued increases in maternal mortality are alarming,” said Dr. Amy VanBlaricom, OBHG Chief Clinical Officer. “There isn’t a simple solution to rapidly improving the situation, either. Multiple factors continue to play a role and it will take the involvement of health systems, communities, lawmakers and families to combat the growing rate of maternal deaths. Access to care is a growing issue in the U.S. with widening maternity deserts that disproportionately impact women of color. OBHG is working closely with rural and small volume delivery hospitals to allow them to provide access to life-saving care within their communities.”
OBHG’s role in addressing maternal mortality
Addressing maternal mortality is a key focus at Ob Hospitalist Group (OBHG). A recent study suggests that hospitals with 24/7 coverage of OB hospitalists have lower levels of severe maternal morbidity than those that use non-hospitalist OB/GYN providers, indicating there is value beyond the simple presence of an obstetrical provider. Not only do OBHG clinicians evaluate patients and handle obstetrical emergencies, but they are also very focused on best practices and safety across the entire labor delivery unit. These are major contributors to the impact OB hospitalists have on positively impacting maternal mortality.
Severe maternal morbidity and mortality are complex problems that require complex solutions.
Working closely with our hospital partners, the women’s health community and healthcare providers, OBHG continues to broaden solutions around maternal morbidity and mortality. We also support policies and actions advancing improved maternal health.
OBHG hospitalist programs are one of the solutions to the growing rate of maternal deaths and are well-situated to help address maternal mortality and morbidity. Here’s how OBHG is working to prevent pregnancy-related deaths and ensure the best possible outcomes:
Access to high-quality maternity care
High-quality maternal care is becoming increasingly difficult to access in the United States. OBHG is ensuring women have 24/7 clinician access in the hospital and is working with rural and small volume delivery hospitals to keep women’s services in the community.
- Managing obstetrics emergencies – No matter the time or day, there is an experienced OBHG-employed hospitalist on-site, ready to evaluate patients and tackle any emergency that may come through the door. OBHG’s continual 24/7 clinician coverage in labor and delivery units across the country, ensures that obstetrics emergencies can be handled immediately instead of minutes or hours later. This approach helps reduce the “delay in care” that is associated with harmful events.
- Improving maternal access to care – So that women don’t have to travel great distances for maternal care, OBHG’s scope has broadened to help hospitals bridge gaps in care. From our experience and success working with hospital partners of all sizes, we know that some hospitals may have most (but not all) of the pieces they need to meet the healthcare needs of the women in the community. We are helping hospitals fill in the gaps with custom-designed solutions distinct from our core OB hospitalist model. This may include an extra set of hands in the hospital, staffing a clinic, or providing coverage from a Certified Nurse Midwife or other provider. Through these solutions, we’re proud to help hospitals address maternal mortality, keep their labor and delivery services open and bring care to communities so that more women can receive maternal care close to home.
- Focusing on postpartum care – To combat the growing rate of maternal deaths occurring postpartum, with OBHG clinicians onsite 24/7, care is available for any patient requiring emergency postpartum care. Our hospitalist teams work closely with our hospital partners to ensure that all patients presenting with pregnancy-related emergencies during the postpartum period are seen by an obstetrician, either in the main emergency department or in the Obstetrics Emergency Department (OBED). Our clinicians are closely aligned with emergency department physicians, providing consultations and management of care for women returning to the hospital weeks and even months after delivery.
- Improving access to care through FQHCs – OBHG is improving access to care and helping hospitals provide care to all pregnant women in the community through OBHG’s support of Federally Qualified Health Centers (FQHC). Through this partnership, OBHG clinicians provide obstetrics and gynecology care, and perform delivery services.
24/7 Qualified clinician presence
OBHG clinicians are skilled in handling obstetrical emergencies and care for every patient equally as they present.
- Addressing disparities and cultural bias – Our team believes that every woman in America should have access to immediate, unbiased care through all stages of pregnancy. With an OBHG program, no matter the day or time, there is an experienced OBHG hospitalist on-site, ready to care for patients and handle any emergency that may come through the door. Factors such as race, ethnicity, geographic region and payer status do not matter. OBHG’s Diversity and Inclusion Committee focuses on ways of closing the gaps in care caused by cultural biases even further while our Quality team measures outcomes by race to ensure equitable care. We are dedicated to ensuring that our diverse clinical workforce (63% female, 40% racial and ethnic minorities) receives regular cultural bias training.
- Ensuring safety across the labor and delivery unit – Not only do OBHG clinicians manage obstetric emergencies, cover labor and delivery, see unassigned obstetrical patients and back up community providers, but our OB hospitalists serve as the maternal safety champion of the entire labor and delivery unit, recommending and implementing proactive strategies not just for our own hospital teams, but in collaboration with hospital leadership and the entire organization’s labor and delivery clinicians. OBHG clinicians also serve as positive examples by adhering to hospital protocols, participating and leading drills and simulations, and advocating for new initiatives.
- Actively supporting community providers – OBHG clinicians are closely aligned with community providers, helping to ensure that patients are the center of the delivery system and we are doing everything possible to ensure they have the safest delivery possible. Our clinicians provide backup support to private practice OB/GYNS should they need an extra hand or can’t make it to the hospital in time – including management of emergent patients, labor management, surgical assists, rounding and discharge. With our presence in the hospital 24/7, our clinicians are ready to provide an on-site emergency response or backup to any of their patients needing urgent care. Our clinicians are also closely aligned with nurse midwives in the community should they need assistance with emergency care.
- Training our experts – At OBHG, advancing initiatives aimed at improving patient safety and quality are always top of mind. Our own clinicians are required to regularly maintain their proficiency in the latest OB/GYN patient safety issues through continuing education. They follow evidence-based medicine and receive frequent training on best practices and protocols in obstetrical care.
Standardized protocols for a multitude of obstetrical emergencies have been shown to be best practice; reducing errors and mitigating personal bias. OBHG hospitalists are the champions of such protocols, including timely treatment of hypertension in the peri- and post-partum time period when many instances of severe maternal morbidity and mortality occur.
- Implementing and sharing best practices – We have seen many examples within our partner hospitals where patient safety has improved because of our clinicians championing standardized protocols. Having the latest protocols in place is critical when it comes to providing the right care in high-risk situations. Our OBHG teams share best practices with our hospital partners and work with them to implement standardized protocols for delivery complications such as preeclampsia and postpartum hemorrhage. We also developed a C-section reduction toolkit to combat medically unnecessary C-sections and have other toolkits underway. Because our partner hospitals are part of a nationwide hospital network, each hospitalist team has access to clinicians across the country to share best practices, educate their peers, and further enhance the quality of care.
- Focusing on quality and data collection – Data collection identifies trends in maternal health and establishes benchmarks for quality improvements. For benchmarking purposes, OBHG tracks data on fetal heart rate monitoring, C-sections, depression screening, and hypertension and track the impact that interventions have throughout the patient care journey in the hospital. We track this data within each of our hospital partners. When a partner hospital falls below a target, OBHG leaders work with hospital leadership to assess the situation and develop an action plan; when a hospital demonstrates differentiated performance, OBHG leaders identify opportunities to bring those results to other programs.
- Developing mental health tools – Recognizing that maternal mental health issues is a leading complication in pregnancy and during the postpartum period, OBHG’s Maternal Mental Health Committee is focused on providing tools to our clinical teams and hospital partners to aid in the identification and treatment of maternal mental health issues. Our teams currently have tools underway for regular mental health screening during the postpartum period.
Advancing women’s health
To further address and help end the maternal health crisis, OBHG is aligned with community providers and organizations.
- Partnering with women’s health organizations – We are dedicated to expanding our efforts by working with industry partners such as the March of Dimes and Preeclampsia Foundation on efforts that align with our mission to improve women’s health. Through our partnership with the Preeclampsia Foundation we are working together to improve the outcomes of hypertensive disorders of pregnancy. (Preeclampsia can quickly turn into an emergency and can lead to maternal death). OBHG’s Rakhi Dimino serves as the Chair of the Preeclampsia Foundation’s Board of Directors.
OBHG clinicians provide feedback on rising maternal deaths and the new CDC report
Two OBHG clinicians were recently in the news, sharing their perspective on rising maternal mortality rates in the United States.
Click here to read Dr. Idalia Rosado-Torres’ perspective in USA Today
Click here to read Dr. Chasity Jennings-Nunez’ perspective in CNN
Would you like to learn more about how we are addressing maternal mortality? Contact us and we’ll share how we are helping hospitals implement a consistent standard of care that helps increase patient safety.