U.S. maternal death rates have increased since 2000, and many of them can be prevented if hospitals standardize care for women in labor, according to an essay published in the New England Journal of Medicine.
The authors recommend that hospitals focus on improving care during three common childbirth complications: heavy bleeding after delivery (postpartum hemorrhage), high blood pressure and blood clots before or after delivery.
If hospitals check each patient for these conditions and use evidence-based protocols to treat them, obstetricians can help curb high maternal death rates, the authors say.
NPR spoke with one of the authors, Kimberlee McKay, MD, who teaches obstetrics and gynecology at the University of South Dakota in Vermillion and oversees obstetrics for Sioux Falls, S.D.-based Avera Health.
Dr. McKay said failure to recognize a maternal health problem is a significant reason that even some large, well-resourced hospitals may not be prepared for common complications during delivery.
"What we've worked really hard on in my own system is to really shore up the recognition piece. We do drills. We have education teams. It really takes a commitment to that," Dr. McKay said. "It takes hospital administrators saying, 'You know what? We're going to give our staff time. We're going to pay them to go in and do these education sessions.'"
In addition to bolstering education efforts, Dr. McKay said it is critical for hospital staff to communicate any changes in a patient's health status.
"When you notice a change in the patient's status, you need to communicate it to the team. Then you make a plan, and everyone is held accountable to the plan," she said. "It seems really like, 'Well, duh, why wouldn't you do it that way?' But in practice, medicine is a very complicated system."
To continue fighting maternal deaths, care providers and hospital administrators must both invest in doing a better job, Dr. McKay said.
"A huge piece of this investment is taking a really hard look at your culture," she said. It's time, it's cost, and it's a great deal of dedication. You've just kind of got to hunker down and do it."