Search Results: MCHLine

Annotation: This web page from the Lifeline for Moms program at UMass Chan Medical School provides resources to help obstetric settings integrate perinatal mental health care into their everyday workflow. The main resource is an Overview Guide, available in two versions: a self-guided version and a remote support version that includes additional materials for virtual meetings with Lifeline for Moms consultants. The Guide includes assessment documents, tools for scheduling implementation and creating practice goals, workflow documents, screeners and scorers for depression, anxiety, PTSD, and self-harm, and resources for developing referral directories and patient handouts. The page also offers an Obstetric Care Clinician Packet with reference materials and patient handouts, as well as a 4-part online training module for obstetric care clinicians and staff. Individual files for each component of the Guide are available for download.

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Keywords: Mental health, Obstetrical care, Perinatal care, Resources for professionals, Service integration

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.

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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

Annotation: This report discusses the importance of integrating oral health care and mental health care into obstetrical care to improve the overall health of women during and after pregnancy. The report explains why poor oral health and mental health may be a particular problem for women during and after pregnancy, and how oral health and mental health are linked. The report also explains the role obstetricians can play in identifying oral health and mental health problems in pregnant and postpartum women.

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Keywords: Gynecology, Mental health, Obstetrical care, Oral health, Pregnant women, Service integration, Statistical data

Annotation: This workbook addresses obstetric emergency triage and care for health care providers, particularly those in nonobstetric settings and maternity care deserts. The workbook presents evidence on the critical access challenges facing pregnant and postpartum patients, noting that one in 12 women live in areas with low or no access to maternal health care and that 41.7% of Missouri counties are defined as maternity care deserts compared to 32.6% nationally. It outlines comprehensive strategies for hospitals without obstetric services, including implementation of education and simulation drills for emergency deliveries and maternal emergencies such as hypertension, sepsis, and hemorrhage, creation of emergency medication kits, use of algorithms and early warning systems, and establishment of partnerships with tertiary medical centers for consultation and transfer agreements. The workbook details the complete Alliance for Innovation on Maternal Health Emergency Triage and Care Patient Safety Bundle components, covering readiness requirements such as rapid response team identification, recognition and prevention measures including pregnancy screening protocols, response protocols for routine births in nonobstetric settings and obstetric emergencies, and reporting and systems learning processes including huddles and debriefs. It emphasizes trauma-informed care principles and respectful, equitable care for all patients, and includes extensive resources for obstetric triage tools, emergency protocols, simulation training materials, transport guidelines, telehealth consultation resources, and patient education materials. The workbook specifically addresses Missouri's challenges with rural hospital closures and provides evidence-based practices to ensure continual readiness for obstetric patients in all hospital settings.

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Keywords: Access to care, Emergency health services, Missouri, Obstetrical care, Resources for professionals, Rural health, State initiatives, Triage

Annotation: This resource workbook for healthcare providers addresses integrating mental health care into obstetric settings to improve outcomes for pregnant and postpartum people. It presents evidence-based guidance including universal screening recommendations for depression, anxiety, bipolar disorder, and post-traumatic stress disorder at multiple points during the perinatal period, with particular emphasis on screening for bipolar disorder prior to initiating antidepressant treatment due to risks of mania, psychosis, and suicide. The workbook advocates for behavioral health therapy as the priority treatment for mild to moderate conditions and stresses the importance of trauma-informed care, anti-racism training, and addressing social drivers of health to create safe environments for disclosure and treatment. It includes the Alliance for Innovation on Maternal Health Perinatal Mental Health Conditions patient safety bundle components organized into readiness, recognition and prevention, response, reporting and systems learning, and respectful care categories. The publication highlights Missouri data showing mental health conditions as the leading cause of pregnancy-related deaths from 2018 to 2020, with suicide deaths doubling and all mental health-related deaths found to be preventable. Resources include screening tools, provider toolkits, educational materials, and information about the Missouri Maternal Health Access Project, a statewide perinatal psychiatry access program.

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Keywords: Mental health, Missouri, Obstetrical care, Perinatal care, Service integration, State Initiatives

Annotation: This iissue brief describes the significance of simulation for obstetric training as a way to improve the quality of clinical practice, including the management of hemorrhage and effective communication with patients and family. The brief also highlights innovative obstetric simulation offerings/programs and explains how academic obstetric and gynecology departments can apply lessons learned from obstetric simulation training and drills conducted in other fields.

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Keywords: Obstetrical care, Professional education, Quality assurance , Training

Annotation: This patient safety bundle was revised in 2023 to incorporate respectful care concepts, revise existing elements, include new elements related to evidence-informed practices, and update data collection plans. The bundle provides actionable steps to support labor and care processes that can be adapted to a variety of facilities and resource levels to improve quality of care and safely reduce cesarean births. Implementation details and resources, a data collection plan, an evidence-informed "change package," and learning modules are included on the website. Some materials are available in English, Spanish, and French.

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• Printable Patient Safety Bundle

Keywords: Cesarean section, Childbirth, Data collection, Measures, Obstetrical care, Prevention, Protocols, Quality improvement, Resources for professionals, Safety, Vaginal birth

Annotation: This toolkit provides actionable information, algorithms, and clinical guidance to support detection, assessment, and treatment of perinatal mood and anxiety disorders. Included is a summary of perinatal mental health conditions; patient screening and treatment guidance; a how-to guide on integrating mental health care into obstetric practice; and educational resources for providers, patients, and families. The toolkit was developed by the UMass Chan Medical School and reviewed by members of the American College of Obstetricians and Gynecologists' Maternal Mental Health Expert Work Group.

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Keywords: Mental health, Obstetrical care, Perinatal care, Service integration

Annotation: This report examines the availability of obstetric care in rural areas in the United States and recommends ways that access to such care can be improved. It focuses on the hospitals and clinicians that provide delivery services and describes (1) the availability of hospital-based obstetric services in rural areas, (2) stakeholder perspectives on factors that affect such availability, and (3) stakeholder perspectives on efforts federal agencies, states, and others could take to increase such availability. Various perspectives from a diverse group of stakeholders (provider associations, patient advocacy groups, researchers, federal agencies, obstetric clinicians and organizations representing different racial and ethnic groups) are presented.

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Keywords: Maternal health, Obstetrical care , Obstetrics, Rural health, Rural hospitals

Annotation: This toolkit provides actionable information, algorithms, and clinical resources to help obstetric providers address perinatal mental health conditions. The toolkit includes guidance on implementing perinatal mental health screening, discussing mental health with patients, and responding to positive screens. It contains patient screening tools for depression, anxiety, and PTSD, as well as provider scoring guides. The toolkit outlines treatment options for mild, moderate, and severe illness, including medication and therapy referrals. It also includes algorithms for assessing risk of suicide and harm to baby, managing bipolar disorder and psychosis, and follow-up treatment. Patient handouts cover an action plan for mood changes, a self-care plan, and educational resources. The appendix provides a summary of perinatal mental health conditions, the PCL-C screening tool for PTSD, follow-up screening forms, and a patient safety screener.

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Keywords: Guidelines, Mental health, Obstetrical care, Perinatal care, Screening, Service integration

Annotation: This report examines the characteristics, quality of care, and quality improvement activities of Medicaid-contracted pediatric and obstetric practices in the fee-for-service or primary care case management delivery systems in Iowa, Arkansas, and Pennsylvania. Although drawn from the experiences of just three states, the study findings presented in the report suggest opportunities for quality improvement in Medicaid pediatric and obstetric care in states across the country. Measures reported by states and pediatric preventive care scores (compared to national averages) are displayed in exhibit tables, and key data findings from individual states are presented as spotlights.

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Keywords: Arkansas, Case management, Comparative analysis, Iowa, Measure, Medicaid, Obstetrical care, Pediatrics, Pennsylvania, Program improvement, Quality assurance, Service delivery systems, State initiatives, data

Annotation: This document provides guidance on and strategies for reducing rates of early elective delivery (EED). Topics include the current landscape for eliminating EED, barriers to reducing EED and strategies to overcome them, challenges and barriers to monitoring performance and progress toward eliminating EED, key strategies to promote readiness for EED activities, and measurement guidance. Additional contents include educational tools, resources, and exemplars to support EED elimination efforts, as well as instructions for accessing relevant data.

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Keywords: Barriers, Cesarean section, Childbirth, Hospitals, Induced labor, Measures, Obstetrical care, Policy development, Program improvement, Quality assurance

Annotation: This new edition offers a review of the basic science and clinical practice of obstetrics and gynecology. It discusses female reproductive anatomy, evaluation, ethics in practice, assessing the quality of medical and surgical care, the human genome, maternal-fetal medicine, reproductive endocrinology, gynecologic oncology. There are more than 225 tables and figures and an updated bibliography. Common presenting symptoms, diagnostic approaches, differential diagnoses, and management are discussed.

Keywords: Bibliographies, Diagnosis, Endometriosis, Enuresis, Ethics, Gynecologic oncology, Gynecology, Laparoscopic surgery, Obstetrical care, Obstetrical surgery, Quality assurance, Reproduction, Textbooks

Annotation: This fact sheet provides information about the increase of cesarean section and its potential to harm women and infants as compared with vaginal birth. Topics include maternal attachment and breastfeeding, future pregnancies, pelvic floor dysfunction, and care providers and place of birth. Tips on reducing the risk for cesarean surgery are included.

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Keywords: Cesarean section, Educational materials, Obstetrical care, Obstetrical complications, Reproductive health, Women's health

Annotation: These recommendations provide guidelines on perinatal systems that are consistent with the Guidelines for Perinatal Care, 6th edition, issued in 2007 by the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists. Guidelines are provided in the following areas: organization, obstetrical unit capabilities, neonatal unit capabilities, obstetric personnel, pediatric personnel, other personnel, laboratory, diagnostic imaging capabilities, equipment, medications, and education program.

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Keywords: Diagnostic imaging, Diagnostic techniques, Education, Guidelines, Health care systems, Laboratories, Neonatal intensive care units, Obstetrical care, Pediatrics, Perinatal care, Perinatal services, Standards

Annotation: This report includes information on the availability of obstetrical services in Virginia and identifies areas in which there is inadequate access. The report also includes information on factors contributing to inadequate access to services, the availability and affordability of malpractice insurance for obstetricians, and specific problems regarding access to obstetrical care for Medicaid and Family Access to Medical Insurance Security enrollees, as well as an assessment of the degree to which these factors may be contributing to the lack of access to obstetrical care in certain areas. The report includes 27 recommendations in six policy areas: Medicaid eligibility; Medicaid reimbursement; medical malpractice insurance; practice and licensure; birth injury; and improving access to care. Twelve appendices include a description of the executive directive, lists of work group members and subcommittees, trends in Medicaid physician payment rates, certification requirements for midwives, summaries of key informant interviews, and more.

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Keywords: Access to health care, Birth injuries, Eligibility, Low income groups, Malpractice insurance, Medicaid, Obstetrical care, Obstetricians, Reimbursement, Underserved communities, Virginia, Women's health

Annotation: This book is about reproductive and health care services available to women through Medicaid managed care. Topics include a brief overview of Medicaid and Medicaid managed care; enrollment issues for women of childbearing age, including recent legislation impacting low income groups; gynecologic and obstetric care; family planning services and access issues; provider issues; adolescent reproductive health services; obstetric case management; and high-risk pregnancy. Reference and a glossary are provided. Four appendices provide information on select provisions of the Balanced Budget Act pertaining to enrollment; a proposal for universal access to maternity care called U.S. MaternaCare; an educational bulletin from the American College of Obstetricians and Gynecologists (ACOG) focusing on psychosocial risk factors: perinatal screening and intervention; and sample patient history intake and medical forms. [Funded in part by the Maternal and Child Health Bureau]

Keywords: Access to health care, American College of Obstetricians and Gynecologists, Childbirth, Gynecology, Internet, Maternal health, Medicaid, Medicaid managed care, Obstetrical care, Postnatal care, Postpartum care, Prenatal care, Reproductive health, Resources, Women's health

Annotation: This book is a compendium of selected clinical practice guidelines in effect as of December 31, 2001, from the American College of Obstetricians and Gynecologists (ACOG), including committee opinions, educational and technical bulletins, practice bulletins, practice patterns, and policy statements. The ACOG code of professional ethics is also included. Each section begins with a complete alphabetical listing of current documents in the series. An index is provided.

Keywords: American College of Obstetricians and Gynecologists, Guidelines, Gynecologists, Obstetrical care, Professional ethics, Professional training, Resources for professionals

Annotation: This book addresses care by nurses and midwives in the preconception, prenatal, and postpartum stages and offers suggestions on the addition of holistic care. Topics include health education, nutrition, physical examinations, laboratory and diagnostic tests, the transition to parenthood, breastfeeding, contraception, and general health issues for women. Patient education materials, sample forms and charts, and guidelines for providing culturally competent care are included in the appendices. An index concludes the book.

Keywords: Educational materials, Manuals, Midwifery, Nursing education, Nursing specialties, Obstetrical nursing, Postpartum care, Preconception care, Prenatal care

Annotation: This book addresses the effects of medical professional liability issues on access to and delivery of obstetrical care. It discusses the medical background of these issues, effects on access to and delivery of obstetrical care to low-income women, liability insurance and the nurse-midwifery practice, and the legal issues. This study was undertaken by the Institute of Medicine following an inquiry by the American Academy of Pediatrics in 1984.

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Keywords: Access to health care, Cesarean section, Genetic screening, Legal issues, Malpractice insurance, Medical liability, Midwives, Obstetrical care