Purpose for the Program
In the United States, two to three women die everyday due to pregnancy-related complications. The three leading causes of national maternal death are eclampsia/preeclampsia, embolism, and hemorrhage. Of these causes, obstetric hemorrhage is known as the most preventable cause of maternal mortality. It is important to study maternal mortality and morbidity for two reasons: First, evidence suggests that at least one-half of pregnancy-related deaths may be preventable through changes in patient, provider, or system factors; and second, mortality rates are disproportionately high among certain racial and ethnic groups. In addition, deaths are only the tip of the iceberg. Maternal morbidity also represents a huge burden of disease for women and their families.
The Illinois Department of Public Health Maternal Mortality Review Committee reviewed 52 cases of maternal death between the years 2001 to 2006. Of those 52 cases, 38% (n = 20) of the maternal deaths were due to hemorrhage. The Maternal Mortality Review Committee found that most mortality cases occurred while women were hospitalized. The Obstetric Hemorrhage Education Project is a response to the Maternal Mortality Review Committee's past and continued findings that a leading cause of maternal morbidity and mortality in Illinois is hemorrhage related and preventable. Developed by the Obstetric Hemorrhage Education Project workgroup, the goal of this educational program is to reduce maternal morbidity and mortality due to obstetric hemorrhage in all birthing hospitals within the state. The program emphasizes a multidisciplinary approach requiring all providers (physicians, registered nurses, certified nurse–midwives, anesthesiologists, and residents) to attend education. The educational requirements of each provider included the completion of a pre- and postprogram benchmark assessment validation, didactic presentation, skill station, and simulation drill.
Implementation, Outcomes, and Evaluation
The outcomes for this project were analyzed and confirm that this type of program is initially very beneficial. Maternal mortality in the United States remains a pressing issue for multiple reasons, the simplest and perhaps most important of which is the reality of an infant and child without a mother, and the consequences for the family as a whole.
Implications for Nursing Practice
Improving maternal mortality involves a committed and long lasting effort on behalf of many individuals along with medical and social organizations to better appreciate the scope of and risk associated with maternal mortality. Discovery of nursing practices that will reduce morbidity and mortality are discussed.