When a mother began to hemorrhage just minutes after delivering her baby, Melissa Grier, MD, didn’t have to race across town or take a frantic phone call from the nurses’ station. She was already there.

“She hemorrhaged so much she went into hemodynamic collapse. Because I was in-house, we were able to intervene right away and proceed with life-saving surgery. Those few minutes made all the difference. She went home to her family,” says Grier, who is the OBHG medical market director in Southern California. 

In a recent OBHG webinar, both Grier and Shauna Depta, MD, vice president of clinician success at Ob Hospitalist Group, shared the stakes of obstetric emergencies and how OB hospitalists can reduce maternal morbidity.

“I’ve had the privilege of being at the bedside for some of the most critical moments in maternal care — catastrophic hemorrhage, sepsis and high-blood-pressure emergencies. Those experiences have reinforced the importance of having an OB hospitalist available at the hospital. Rapid recognition and response can truly be the difference between life and death,” says Dr. Grier.

Click here to watch the webinar. 

The numbers behind the urgency

For its medical sophistication, the United States continues to face one of the highest maternal mortality rates among peer nations. In the most recent national data from the CDC, 87% of pregnancy-related deaths were deemed preventable by state maternal mortality review committees. Maternal mortality remains highest among minority populations. 

These statistics are exactly why clinicians like Dr. Grier and Dr. Depta have devoted their careers to promoting the hospitalist model. “The data is shocking for all of us, and it really shows the need for all of us as obstetricians to dive into quality and systems,” says Dr. Depta.

The following are some key statistics from the CDC maternal mortality data in 2021, the most recent year statistics are available: 

• 87% of pregnancy-related deaths were preventable
• Infection was the leading cause, followed by mental health conditions
• 83% of the deaths attributed to infection were related to COVID-19
• Substance use disorder contributed to 63% of mental health deaths
• Most prevention recommendations were at the system level

These are stark statistics. At the same time, single-site and regional studies report statistically significant reductions in serious safety events following the implementation of hospitalist programs.

Why having OB hospitalists present matters

Rather than juggling office appointments or driving between sites, OB hospitalists are on site 24/7. Their constant presence changes the equation when minutes or even seconds matter.

“The traditional model of care where the obstetrician is not in the hospital makes the ‘rapid’ part of rapid response more difficult, so being on site really helps improve the pace of delivery of care,” says Dr. Grier. 

Dr. Depta recalls a particular story—one of many — over her 13 years as an OB hospitalist. She was called to the ICU for a pregnant patient who came in for an infection and was about to be dismissed to a step-down unit. “Her doctor was in her office, and the patient coded, so I did a C-section right there in the ICU as she was getting compressions,” she says. 

The mother was resuscitated, and the preterm baby did well. “If there hadn’t been anybody in-house to do that, it probably would have been a very different outcome,” says Dr. Depta. 

Simply put, when minutes matter, the hospitalist model means there’s someone available in the room immediately. 

How OB hospitalists advance safety

From early intervention to improving hospital protocols and working as a team, OB hospitalists advance patient safety and reduce maternal morbidity and mortality. 

Early identification and timely intervention

Any OB/GYN who’s worked in a hospital setting can recall many times when a patient hits the door completely dilated and breached, with a core prolapse or with an abruption. An OB hospitalist embedded in an OB emergency department (OBED) can achieve door-to-doc times measured in minutes, not the variable waits of traditional triage models. “Just being there as the first responder, with immediate response time, ensures patients are treated quickly,” says Dr. Depta.

Maternal sepsis is a classic example of how early intervention from OB hospitalists can reduce maternal mortality. Not only are they available on site immediately, but hospitalists are also key to educating everyone to use life-saving toolkits, like the early recognition of sepsis from CMQCC. 

Improving hospital protocols

Because OB hospitalists work full-time in the hospital, they tend to have more time to standardize care and improve protocols. Deploying toolkits and simulations, like the CMQCC obstetric sepsis v2.0, provide reliable and scalable pathways. Hospitalists are the ideal candidates to help teams on the ground hard-wire these protocols into default practice. 

Treating a severe range of high blood pressures is a classic example of how having an OB hospitalist on-site improves patient safety. “Because we’re there, we’re able to initiate hypertensive pathways to bring the blood pressure into a more normal range, and that really is life-saving for many patients,” says Dr. Grier.

Treating high blood pressure as an emergency has helped improve maternal care protocols. “Years ago, units could be a bit lackadaisical about hypertension or sepsis protocols. Today, because hospitalists and nurses train together, those responses are hard-wired. If a patient has a severe-range blood pressure, the nurse knows exactly what to do and when. We’re starting magnesium, antihypertensives and IVs within minutes, not an hour,” says Dr. Depta.

Teamwork

OB hospitalists who work full-time in a hospital setting can build a cohesive team that works together to improve care. Collaborating in real-time and in simulations reinforces a shared mental model across nursing, anesthesia, NICU, blood bank and even OB community physicians. Together, they can develop an automatic sequence for activation. “Having the same group of people always available to be the first responders to critical care and obstetrics allows for a standard approach, which really is also going to advance safety and improve outcomes,” says Dr. Grier.

Training

OBHG staff work closely with their teams on the ground to run simulations and debrief after incidents. This helps everyone implement best practices quickly on autopilot during an emergency.

“We run simulations three times a month. We debrief every scenario, even drills. That consistency creates a shared mental model where you know who’s calling anesthesia, who’s opening the OR and who’s managing the hemorrhage cart. When an emergency hits, the team just moves,” says Dr. Grier.

Ensuring all patients have access to equitable care

Maternal mortality in the United States remains highest among minority populations. Both Dr. Grier and Dr. Depta agree that standardizing practice protocols is one of the best weapons for combating bias. “Standardized protocols level the playing field. When every patient with 160 over 110 gets treated, there’s no room for bias or hesitation,” says Dr. Depta.

A new standard for maternal safety

While the maternal mortality statistics in the United States are daunting, the progress OB/GYNs and OB hospitalists, especially, are making is hopeful. Each rapid response, standardized protocol and debrief adds up to a new safety net for mothers and babies.

“Of all the things we do, making the right thing happen for the patients and to prevent deaths that otherwise could be prevented is the most important thing,” says Dr. Depta.

In a field where minutes can mean lives, the hospitalist model isn’t just a staffing solution—it’s a movement toward reliability, equity, and safety.

Contact our recruiting department for more information on current openings and how to join us in making a difference in women’s healthcare.