Improving maternal and infant outcomes in the United States is a top priority for the AHA and our member hospitals and health systems. While the field has worked hard to improve maternal morbidity and mortality, we must continue to work toward reducing health disparities. Mothers can be at risk from the first days of pregnancy through the postpartum period and beyond. Hospitals, health systems, clinicians and their community partners are dedicated to improving care for mothers and infants.
OUR SHARED GOAL:
Eliminate preventable maternal mortality and reduce morbidity related to pregnancy and childbirth.
Core Principles
The AHA encourages hospitals and health systems to apply these four core principles into their maternal and child health efforts.
1.Examine quality and outcomes data to guide strategy:
Systematically collect data, review metrics and identify disparities to drive strategies for improvement in health outcomes.
KEY ACTIONS
- Consistently track and review maternal morbidity and mortality data from your patient population as well as data from your community, region and state.
- Stratify data by variables appropriate to your community to identify disparities in care and outcomes.
- Investigate root causes of poor pregnancy outcomes including housing security, food security, health literacy, access to prenatal care, toxic stress, etc.
- Deploy a systematic approach to review maternal health complications and implement strategies for improvement (e.g., maternal mortality review committee).
- Identify opportunities to improve outcomes during pregnancy, labor and delivery, and postpartum.
- Implement strategies to address medical causes of maternal morbidity and mortality across the continuum of pregnancy and postpartum including hypertension/cardiovascular disease, hemorrhage, sepsis, gestational diabetes and behavioral health.
2. Consider the causes of disparities in health outcomes
Investigate how clinical and community-based strategies work toward reducing disparate outcomes.
KEY ACTIONS
- Deploy care strategies to address disparities identified in your data.
- Consider how care delivery strategies could impact subsections of your population differently and tailor care to meet the needs of your community.
- Explore whose voices and perspectives are shaping your initiatives – and whose voices may be missing.
- Partner with community-based organizations and other stakeholders to improve person-centered care, health literacy, address societal factors and provide wraparound services.
3. Involve patients and community in their own care
Engage patients, families and community stakeholders to design care that is responsive to their needs and preferences.
KEY ACTIONS
- Gather feedback from pregnant and postpartum women to ensure that programs meet the needs and preferences of community members.
- Create opportunities that empower patients and community members to share their care preferences, such as patient and family advisory councils.
- Establish forums for expecting and new moms to connect with one another and with community-based groups.
- Develop processes to screen for and address the social needs of pregnant women and new moms.
- Engage and partner with community-based groups to foster seamless care transitions between hospital and community-based providers, particularly for high-risk moms.
- Engage dads and other caregivers throughout pregnancy and postpartum care.
4. Engage the workforce
Deploy interdisciplinary care teams who are trained to provide person-centered care.
KEY ACTIONS
- Customize your maternal health care teams to include nurse-midwives, doulas, community health workers, and behavioral health specialists to provide holistic care aligned with your patient population’s needs.
- Equip care team members with skills that foster active, empathetic interactions between patient and provider.
- Recruit providers that are reflective of your community and consider workforce development pathways.
