Alliance for Innovation on Maternal Health: Evolution of a program to address maternal morbidity and mortality

The Alliance for Innovation on Maternal Health program is a national investment in promoting safe care for every birth in the United States and lowering rates of preventable maternal mortality and severe maternal morbidity. Through its work with state and jurisdiction-based teams on patient safety bundle implementation, the program supports data-driven quality improvement. This paper details key aspects of the Alliance for Innovation on Maternal Health including patient safety bundles, technical assistance, implementation resource development, data support, and partnerships while providing an overview of the program's evolution, reach, impact, and future opportunities.

Maternal Quality Outcomes and Cost

The quality of maternal care in the United States is receiving increased attention due to rising rates of severe maternal morbidity and maternal mortality when compared with other developed countries. Many of these events are considered preventable. The lack of adoption of evidence-based maternal patient safety bundles and tool kits requires immediate attention. Maternal levels of care described by the American Congress of Obstetricians and Gynecologists requires increased focus so that women are in the appropriate facility to receive care. Perinatal care management, integrated behavioral health, and preconception care should be considered a preferred methodology to achieve optimal maternal outcomes.

Obstetric hemorrhage: A global review

Postpartum hemorrhage remains the number one cause of maternal death globally despite the fact that it is largely a preventable and most often a treatable condition. While the global problem is appreciated, some may not realize that in the United States postpartum hemorrhage is a leading cause of mortality and unfortunately, the incidence is on the rise. In New York, obstetric hemorrhage is the second leading cause of maternal mortality in the state. National data suggests that hemorrhage is disproportionally overrepresented as a contributor to severe maternal morbidity and we suspect as we explore further this will be true in New York State as well. Given the persistent and significant contribution to maternal mortality, it may be useful to analyze the persistence of this largely preventable cause of death within the framework of the historic "Three Delays" model of maternal mortality. The ongoing national and statewide problem with postpartum hemorrhage will be reviewed in this context of delays in an effort to inform potential solutions.