Abby Block, CD(DONA), CBC

Doula & Breastfeeding Support ~ Serving Brooklyn & NYC

POSTBIRTH - An Acronym that Can Reduce Maternal Mortality and Morbidity in the Postpartum Period

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POSTBIRTH - An Acronym that Can Reduce Maternal Mortality and Morbidity in the Postpartum Period

by Sharon Muza, BS, LCCE, FACCE, CD(DONA), BDT(DONA), CLE

Full text of the article can be found here.

Maternal mortality and morbidity in the United States are as high as they have ever been.  More people are dying from complications of pregnancy or childbirth than ever before.  61 percent of deaths related to childbirth occur in the postpartum period and most of those occur in the first 42 days after birth. The current estimated maternal mortality rate in the U.S. is 23.7/100,000 live births (MacDorman, Declercq, Cabral, & Morton, 2016).  

There is agreement that we must improve the way we care for people in the postpartum period if we want to be able to reduce the complications and deaths that occur after giving birth.  Part of this improvement lies in how warning signs information is provided to families after birth.  As it is not possible to identify who will have a postbirth complication, it is imperative that everyone receive information about concerns in the postpartum period that will need to be evaluated by a health care provider.  The postpartum nurse or mother-baby nurse is in a unique position to educate families on what to watch for postpartum.

Unfortunately, current research indicates that the information that postpartum nurses teach to new parents about warning signs is inconsistent and often inaccurate.  There is also evidence that many postpartum nurses are not aware of the major risks that face people after they give birth that can cause death or serious complications.  Families report being flooded with physical and emotional situations in the first days postpartum that make it difficult to take in important information accurately and clearly.   For these reasons, the postpartum discharge education RNs provide must be clear, concise, and accurate. When appropriately informed and educated, postpartum nurses are in an ideal position to improve postbirth outcomes, if they are given adequate time to share information with the new family.

A new study, Nursesʼ Knowledge and Teaching of Possible Postpartum Complications, published in MCN: The American Journal of Maternal/Child Nursing, examines postpartum nurses’ knowledge of maternal morbidity and mortality, and information they shared with women before discharge about identifying potential warning signs of postpartum complications. 

Almost half the postpartum nurses in the study were not aware that maternal mortality rates have increased.  Almost all (93%) of nurses knew that hemorrhage was one of the top three causes of death, but only 68% knew that hypertension was another, and barely 39% could identify infection as the third leading cause of death.