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Strengthen the Evidence for Maternal and Child Health Programs

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Items in this list may be obtained from the sources cited. Contact information reflects the most current data about the source that has been provided to the MCH Digital Library.

Displaying records 1 through 6 (6 total).

Missouri Perinatal Quality Collaborative. 2025. Cardiac conditions in obstetric care resource workbook. Jefferson City, MO: Missouri Perinatal Quality Collaborative, 16 pp.

Annotation: This workbook provides guidance for implementing evidence-based practices to improve care for pregnant and postpartum individuals with cardiovascular disease (CVD). It summarizes the evidence on the significant risks of CVD in pregnancy, which can exacerbate pre-existing conditions or lead to new disorders due to the hemodynamic changes of pregnancy. The workbook presents data from Missouri's Pregnancy-Associated Mortality Review, finding that CVD accounted for 30% of pregnancy-related deaths from 2017-2021, with most deemed preventable and Black women disproportionately impacted. To address this crisis, the AIM Cardiac Conditions in Obstetric Care patient safety bundle components are provided, with detailed strategies for implementing universal cardiac risk screening, rapid response protocols, cardio-obstetric teams, care coordination, patient education, and equity-focused data monitoring. Emphasis is placed on early recognition, diagnosis, and treatment to prevent complications and death. Resources and references are included for further training and implementation.

Keywords: Cardiovascular diseases, Evidence-based medicine, Guidelines, Maternal morbidity, Maternal mortality, Missouri, Obstetrical complications, Perinatal care, Postpartum care, Prevention, Quality improvement, Resources for professionals, State initiatives

Missouri Perinatal Quality Collaborative. 2024. Obstetric hemorrhage resource workbook. Jefferson City, MO: Missouri Perinatal Quality Collaborative, 16 pp.

Annotation: The workbook outlines evidence-based practices for improving recognition of and response to obstetric hemorrhage, including hemorrhage risk assessments categorized as low, medium, and high risk that should be completed on admission, during labor, and post-delivery. It emphasizes the critical importance of quantification of blood loss using volumetric containers, weighing scales, or computerized image recognition rather than estimation, as postpartum hemorrhage occurs in about 40% of low-risk birthing people. The workbook presents the Alliance for Innovation on Maternal Health Patient Safety Bundle components, which include stage-based management plans, hemorrhage supply carts, immediate access to hemorrhage medications, standardized education for obstetric teams, multidisciplinary drills, and case review processes. It addresses Missouri-specific data showing obstetric hemorrhage as the fourth leading cause of pregnancy-related deaths from 2018-2020, with significant racial disparities in transfusion rates, and notes that between 54% to 90% of hemorrhage-related deaths are preventable. The workbook includes extensive resources for implementation including assessment tools, quantification worksheets, stage-based guidelines, simulation training materials, and patient debriefing forms, and provides trauma-informed guidance for supporting patients and families after hemorrhage events.

Keywords: Emergency medical services, Hemorrhage, Missouri, Obstetric care, Obstetric complications, Postpartum hemorrhage, Quality improvement, State MCH Programs

Woo M, Glover A. 2021. Severe maternal morbidity in Montana: Near-miss obstetric events in a rural state. Missoula, MT: University of Montana Rural Institute for Inclusive Communities and the Montana Hospital Association,

Annotation: This report presents an analysis of severe maternal morbidity (SMM) among Montana residents who delivered in Montana hospitals from 2016-2018, using hospital discharge data. SMM refers to life-threatening obstetric complications that lead to significant short-term or long-term consequences. The report uses the CDC's ICD-10 based definition to identify SMM cases and rates. Key findings include: an overall SMM rate of 110.5 per 10,000 delivery hospitalizations; blood transfusion as the most common SMM indicator followed by hysterectomy and acute renal failure; and increased risk of SMM associated with Medicaid coverage, younger (<20 years) and older (≥35 years) age, residence in very rural counties, and American Indian/Alaska Native race. In particular, American Indian/Alaska Native individuals had triple the risk of SMM compared to white individuals, and those in the most rural counties had nearly double the risk compared to those in small metropolitan counties. The report discusses the intersecting racial and geographic disparities and provides recommendations to alleviate SMM through focused, culturally-sensitive, rurally-tailored care and prevention efforts in partnership with impacted communities. It also examines SMM in the context of severe hypertension and hemorrhage to inform state maternal safety initiatives.

Keywords: Data, Maternal morbidity, Montana, Obstetric labor complications, Rural health, State initiatives

Coalition for Improving Maternity Services. 2010. The risks of cesarean section. Raleigh, NC: Coalition for Improving Maternity Services, 8 pp.

U.S. Bureau of Community Health Services. 1975, 1977. Studies in maternal health: Research to improve health services for mothers and children . Rockville, MD: U.S. Bureau of Community Health Services, 2 v.

California Maternal Quality Care Collaborative. California Maternal Quality Care Collaborative toolkits . Palto Alto, CA: California Maternal Quality Care Collaborative,

Annotation: This collection of toolkits and related resources guides hospitals and healthcare systems in adopting quality improvement strategies to enhance maternal safety and outcomes. The major topics covered by the toolkits address critical areas of maternal health: (1) Cardiovascular Disease, including improving health care response in pregnancy and postpartum; (2) Early Elective Deliveries, focusing on eliminating non-medically indicated deliveries before 39 weeks gestational age; (3) Hemorrhage, specifically improving health care response to obstetric hemorrhage; (4) Hypertensive Disorders of Pregnancy, focusing on improving health care response; (5) Sepsis, detailing improvement for diagnosis and treatment of obstetric sepsis; (6) Substance Exposure (Mother & Baby), providing resources for substance exposure; (7) Supporting Vaginal Birth, including strategies to reduce primary cesareans; and (8) Venous Thromboembolism, focusing on improving health care response to maternal venous thromboembolism.

Keywords: California, Guidelines, Obstetrical complications, Patient safety, Postpartum care, Prenatal care, Resources for professionals, Risk management, State initiatives
   

The MCH Library is one of six special collections at Georgetown University, the nation's oldest Jesuit institution of higher education. The library is supported through foundation, private, university, state, and federal funding. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by Georgetown University or the U.S. Government. Note: web pages whose development was supported by federal government grants are being reviewed to comply with applicable Executive Orders.