Postpartum Gray Literature

Annotation: This report presents findings from the Maryland Maternal Health Innovation Program's (MDMOM) facility-based Severe Maternal Morbidity (SMM) Surveillance and Review program for 2023, covering 279 SMM events identified at 27 participating hospitals representing more than 80% of births in the state. The program uses a standardized case definition of intensive care unit admission and/or transfusion of four or more units of blood products for pregnant and postpartum patients up to 42 days. Hospital review committees analyzed events to determine preventability, identify contributing factors, and develop recommendations organized by the "5Rs" framework of readiness, recognition and prevention, response, reporting and system learning, and respectful care. The report documents that 34% of SMM events were potentially preventable, with obstetric hemorrhage being the most common primary cause, and includes detailed analysis of demographic characteristics, timing of events, delivery outcomes, and specific recommendations for preventing future severe maternal morbidity by cause.

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Keywords: Maryland, Maternal morbidity, Maternal mortality, Population surveillance, Postpartum hemorrhage, Prevention, Standards

Annotation: This report presents findings from the Maryland Maternal Health Innovation Program's (MDMOM) facility-based Severe Maternal Morbidity (SMM) Surveillance and Review program for 2024, analyzing 340 SMM events identified at participating hospitals following the passage of the Maternal Health Act of 2024 requiring all birthing hospitals in the state to participate in SMM surveillance beginning in 2025. The program uses a standardized case definition of intensive care unit admission and/or transfusion of four or more units of blood products for pregnant and postpartum patients up to 42 days postpartum. Hospital review committees analyzed events to determine preventability, identify contributing factors, and develop recommendations organized by the "5Rs" framework of readiness, recognition and prevention, response, reporting and system learning, and respectful care. The report documents that 32% of SMM events were potentially preventable, with obstetric hemorrhage being the most common primary cause, and includes demographic characteristics, delivery outcomes, and specific recommendations for preventing future severe maternal morbidity by cause and racial/ethnic disparities in SMM rates.

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Keywords: Maryland, Maternal morbidity, Maternal mortality, Population surveillance, Postpartum hemorrhage, Prevention, Standards

Annotation: This toolkit provides home visiting programs with client education materials and implementation tools to support maternal warning signs education. This education covers the important signs of maternal complications that may occur during pregnancy and the year after delivery. The toolkit includes an illustrated handout and discussion guide available in 12 languages, a video available in English, Spanish and French, a magnet, and online training for home visitors with an implementation manual. The materials are designed for home visitors working with pregnant and postpartum clients to educate them about urgent maternal warning signs that require immediate medical attention. All digital resources are available through a shared Google Drive folder.

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Keywords: Home visits, Maternal mortality, Patient education materials, Prevention, Resources for professionals

Annotation: This video presents an educational presentation by Dr. Shari Lawson, a general obstetrician gynecologist at Johns Hopkins Hospital, covering urgent maternal warning signs for pregnant and postpartum women up to two months after delivery. The presentation discusses signs of preeclampsia including severe headaches, vision changes, extreme swelling, and severe nausea; other pregnancy warning signs such as severe abdominal pain, vaginal bleeding, and decreased fetal movement; postpartum complications including heavy bleeding and blood clots; and mental health concerns including depression and thoughts of self-harm. The video emphasizes the importance of seeking immediate medical attention when experiencing these symptoms and encourages sharing this information with family members to support maternal health. This video is available in English, Spanish and French as part of a comprehensive maternal warning signs toolkit for home visiting programs.

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Keywords: Maternal mortality, Patient education materials, Prevention

Annotation: This interactive map displays resources and services available to pregnant and postpartum women and their families in Maryland. Users can click on more than two dozen categories, including CenteringPregnancy sites, birthing hospitals, family planning clinics, home visiting programs, and care coordination and navigation services, to learn where in the state they can locate assistance. Resources listed on the map have been verified and confirmed to be offering the services listed and, where applicable, with licensed and credentialed human resources at the time of the last update (posted on the site). The map was developed at the recommendation of the Maryland Maternal Health Innovation Task Force as part of the Maryland Maternal Health Innovation program (MDMOM) funded by the Health Resources and Services Administration.

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Keywords: Access to care, Health services, Maps, Maryland, Maternal health, Perinatal care, Postpartum care, Prenatal care, Resource materials, State initiatives