Stop. Look. Listen! Page 8

The Safe Motherhood Initiative

In January 2013, leaders in obstetric care from across New York
State convened at a meeting sponsored by

ACOG District II

strategize on clinical, educational, surgical and research initiatives
to reduce maternal mortality and severe morbidity in New York
State. ACOG District II has secured funding from Merck for
Mothers for a comprehensive educational and research program to
reduce maternal mortality. Through an iterative process, clinical
measures with the potential to reduce maternal morbidity and
mortality were identified and endorsed.

In developing a systematic strategy to reduce maternal mortality,
the challenges New York State faces are representative of the
United States as a whole. Nationally, obstetrical care is provided in
diverse clinical settings, so that success in reducing maternal
mortality is contingent on addressing sources of maternal
morbidity and mortality which may differ in small, medium, and
large academic and community obstetric centers.

Obstetric leaders in New York State have taken a mutual pledge to
help facilitate a landmark change in the way obstetric care is
provided by seeking to ensure that all hospitals have a systematic
and comprehensive framework by which to operate. The corner-
stone of the ACOG District II endeavor, entitled,

The Safe

Motherhood Initiative

, consists of local hospital sessions to

educate maternity teams on how to successfully standardize care
and eliminate variation statewide. This is an intense three-year
commitment hospital and their labor and delivery staff.

Every birthing facility should have a system of support for staff,
families and patients who have been involved in a severe maternal
event. ACOG District II, working with the

Tara Hansen

Foundation

and other similar associations, aims to improve

patient safety and reduce the rate of adverse maternal outcomes
through education, support and patient and family collaboration.

Mary D'Alton, MD, FACOG

Willard C. Rappleye Professor of Obstetrics and Gynecology
Chair, Department of Obstetrics and Gynecology
Columbia University Medical Center
Director, Ob/Gyn Services
NewYork-Presbyterian/Sloane Hospital for Women

Cynthia Chazotte, MD, FACOG

Professor and Vice Chair
Department of Obstetrics & Gynecology and
Women's Health
Albert Einstein College of Medicine/
Montefiore Medical Center

What is the Safe Motherhood Initiative?

The Safe Motherhood Initiative (SMI) is a multi-year,
multi-stakeholder project comprised of nurses, midwives,
physicians, patient safety specialists, and other partners in
New York State working together to standardize care in
all obstetric hospitals to prevent

obstetric emergencies

associated with maternal mortality and morbidity

The SMI focuses on the three leading causes of maternal
death obstetric hemorrhage, severe hypertension in
pregnancy, and venous thromboembolism.

The SMI has been working with a team of clinical experts
since January 2013 to develop, implement, and evaluate
evidence-based practices which have resulted in the
formation of maternal safety bundles for these three
causes of death.

These three bundles (

obstetric hemorrhage, severe

hypertension in pregnancy, and venous thromboembolism

)

consist of a variety of step-by-step, evidence-based tools
to manage risk, prevent adverse events, respond, and
debrief. Examples of tools include key elements, protocols,
checklists, algorithms, laminated posters, etc.

New York State is joining New Jersey, California, Florida,
Georgia, and Washington, D.C., in implementation of
parallel maternal safety projects.

The SMI is funded by Merck for Mothers, a 10-year
commitment to tackle the leading causes of death during
pregnancy and childbirth globally, including here in the
United States.