“Most pregnancy-related deaths are preventable, demonstrating the need to identify and implement strategies to address the multiple contributing factors.” That sentence in a report by the US Centers for Disease Control and Prevention (CDC) captured my attention.
Why does the United States continue to have troubling rates of pregnancy-related deaths for moms—most of which were preventable—despite significant advances in medical care? Why do black mothers have a higher risk than any other group?
To be clear, there are many unanswered questions. Healthcare accrediting agency The Joint Commission, though, studied the issue and identified two specific areas where focus can help reverse the concerning maternal mortality trend.
Medical research shows that there are two areas that cause most pregnancy-related maternal injuries and death:
• Maternal hemorrhaging: Excessive blood loss during labor or following delivery. The Joint Commission identified this as the number one cause of maternal death during pregnancy.
• Preeclampsia: Severe hypertension or high blood pressure during pregnancy. Preeclampsia is life-threatening, but can be difficult to identify because some of the symptoms overlap with general pregnancy discomfort. This condition is one reason why regular prenatal care and blood pressure monitoring are necessary.
Maternal hemorrhaging
Current standards of The Joint Commission require hospitals to undertake the following actions to prevent and prepare for maternal hemorrhaging:
• Complete an assessment using an evidence-based tool for determining maternal hemorrhage risk on admission to labor and delivery and on admission to postpartum.
• Develop written procedures for state-based management of pregnant and postpartum patients who experience maternal hemorrhage.
• Equip each obstetric unit with standardized, secured, dedicated hemorrhage supply kits that must be restocked per a defined process. These kits must contain emergency hemorrhage supplies.
• Provide role-specific education to all staff and providers who treat pregnant and postoperative patients about hemorrhage procedures. This education and training needs to occur during orientation and at least every two years.
• Conduct hemorrhage response drills at least annually to identify areas that need improvement.
• Review hemorrhage cases that occur to look for lessons learned.
• Provide patient and family education about the signs and symptoms of postpartum hemorrhaging.
Preeclampsia
Similarly, The Joint Commission issued current standards designed to help hospitals reduce the likelihood of harm related to preeclampsia or maternal severe hypertension. The standards include:
• Develop procedures for measuring and remeasuring blood pressure, including setting forth procedures to identify patients with severely elevated blood pressure.
• Develop written procedures for managing pregnant and postpartum patients with severe hypertension/preeclampsia.
• Provide role-specific education to all staff and providers involved in the treatment of pregnant and postpartum patients about the hospital’s hypertension/preeclampsia procedures. This education occurs at orientation, whenever changes to the procedure occur, or every two years.
• Conduct preeclampsia emergency response drills.
• Provide patient and family education about the signs of severe hypertension/preeclampsia.
As a former hospital administrator, I welcome the accreditation requirements to reduce the risk of maternal death during pregnancy. At Painter Law Firm, we’ve handled a number of cases involving severe injuries and deaths to mothers because of undiagnosed or improperly treated preeclampsia and hemorrhaging.
If you’ve been seriously injured because of poor prenatal or labor and delivery care in Texas, then contact a top-rated experienced Texas medical malpractice lawyer for a free consultation about your potential case.
