x
Breaking News
More () »

How Midlands hospitals are working to prevent maternal deaths

In South Carolina, more than 26 moms die every year from pregnancy complications, according to the Centers for Disease Control and Prevention.

Columbia, SC (WLTX) -- Healthcare leaders across the Palmetto State are making moves to prevent deaths among new mothers.

In South Carolina, more than 26 moms die every year from pregnancy complications, according to the Centers for Disease Control and Prevention. That's higher than the national average of 20.

In the states with the highest death rates among new mothers, South Carolina ranks 8th.

"Hemorrhage is still a leading cause of death, but cardiovascular conditions are number two, and hypertension contributes to cardiovascular conditions," said Dr. Judy Burgis, Academic Chair for OB/GYN at Palmetto Health USC Medical Group.

Research shows nationwide the majority of these deaths were preventable.

In 2014, a grant funded by the Health Resources and Services Administration created the Alliance for Innovation on Maternal Health (AIM), convened by the American College of Obstetricians and Gynecologists (ACOG).

"To basically change the system, change the culture of how we deliver care for moms and for babies," said Dr. Barbara Levy, Vice President for Health Policy for the American College of Obstetricians and Gynecologists.

As for the rise in the maternal mortality rate nationwide and in South Carolina, Dr. Levy says there is no simple answer; Multiple factors play a role.

For example, mothers are having babies at a more mature age now compared to many of our own mothers. The number of c-sections is also going up, posing a potential risk to mothers who have undergone the surgery multiple times.

"What we do know is that the delivery of health care is a system, and to fix it or improve things, we have to address the whole system," said Levy.

To join the AIM Program, a state must create it's own team of health care leaders.

"Nurses, doctors, anesthesiologists, blood banks, hospital administrators," said Levy.

The group of leaders will be dedicated in working to improve the maternal mortality rates in each state. EMT's, for example, will learn certain symptoms to look for if they know their patient just had a baby.

An AIM participant must also form a Maternal Mortality and Morbidity Review Committee (MMRC) and supply their own data on maternal health.

South Carolina is taking action to join.

"Incorporating standardized protocols for care of patients will eliminate variation in care and help us use evidence-based ways to treat like conditions," said Dr. Judy Burgis, Academic Chair for OB/GYN at Palmetto Health USC Medical Group.

Dr. Burgis says in South Carolina, we have our own MMRC working to help mothers safely deliver babies.

In 2016, a multi-disciplinary committee was established in the state to examine maternal deaths and look for any systems issues. Dr. Burgis says one of the questions they ask in the event of a death: Was it related to the pregnancy?

"If the woman had not been pregnant, would she have died? If the answer to that is pregnancy aggravated her death, we go through that and examine that to look for ways to help moms in the future," she said.

Palmetto Health is also in the process of establishing a Women's Service Line.

"A system-wide adoption of the maternal hemorrhage bundle and the maternal hypertension bundle," said Burgis. "So that will address the two most preventable causes of maternal death in our state."

Patient safety bundles by AIM are key. Anyone can access them online. Bundles are activities that when done together will improve care in a hospital. Bundles are offered for a variety of scenarios.

They are not protocols.

Safety bundles talk about four things: Being ready for a problem, recognizing the problem when it happens, how hospitals respond to it and reporting.

"Debriefing after an event to say what went well, what didn't go well, what could we do better so we continuously improve," said Levy. "Even though the mortality rate is going up, the absolute numbers are not that big. So any one hospital is unlikely to have seen a major problem this year. It's not top of mind for people. That's why the bundles are so very important to have everything ready when that catastrophe occurs."

South Carolina is also sponsoring a mobile obstetric emergency simulator coach.

"This coach visits every birthing hospital at least once a year to let teams of physicians and nurses practice on simulation," said Burgis.

At Lexington Medical Center, they hold ongoing staff training and drills, on top of the simulation lab. Their Labor and Delivery Unit has specific protocol and specialty equipment, like a hemorrhage cart, to treat any emergency situation. They have obstetricians and certified nurse midwives on-call at the hospital around the clock in case of an emergency, and they conduct reviews or debriefings of all maternal hemorrhages to learn how to improve in the future.

This fall, Lexington Medical Center OB/GYNs are encouraging pregnant patients to get flu shots as soon as possible after the first trimester. The mortality rate for the flu is 10 times higher in pregnant women compared to women who are not pregnant.

In the future, Dr. Burgis says health leaders in South Carolina will begin to look at emerging issues such as domestic violence, mental health conditions and alcohol and drug abuse to see how they affect maternal health.

What can you do to help ensure you're getting proper care? Dr. Levy says when you go on a tour of a hospital or facility, ask if they are committed to patient safety. You can ask if they conduct drills and simulations, and inquire about patient safety bundles they have in place.

The Alliance for Innovation on Maternal Health is looking for additional funding to acquire the adequate amount of resources to provide quality support for members. If you are interested in helping, please e-mail quality@acog.org.

Before You Leave, Check This Out