What social factors place this pregnant woman at risk of adverse outcomes:
Insurance coverage, economic status, level of family support, living situation, level of life stressors.
Do I have an underlying bias against this patient?
Examples of implicit biases against black mothers:
Assuming that she is a single mother or unfit to have children and treating her differently because of that perception
Become familiar with the local and national efforts being used to address maternal mortality
Are there local community providers that offer free services for pregnant women and new mothers?
Assess the maternal mortality risk in your patient
Did this patient have adequate prenatal care?
Was this a planned pregnancy?
Based on her gestation level, what is she most at risk of at THIS moment? If postpartum, what about her medical history or any complications from delivery can still result in an adverse outcome?
Think how can I make sure this patient understands warning signs and symptoms to look out for?
If postpartum, does this mother have the tools and support she needs so that if she feels like something is wrong, she can receive immediate care.
Are there risk calculators? If so include them
Approach patient and give them information/resources that discuss their elevated risk
Provide recommendations to address the elevated risk
Ob/Gyn
Physician training on incorporating cultural sensitivity into care.
Policies to hold providers and hospitals accountable if they fail to provide unbiased, high-quality and evidence based care
Creative ways to provide information on warning signs mothers should look out for after giving birth:
magnets for fridge, sticker, ect.
Family & Internal Medicine
Effective transition of care postpartum from Ob/Gyn to primary care.
Provide information about local community providers that offer services for new mothers or pregnant women.
Emergency Medicine
Make sure all Emergency departments are equipped with birthing supplies that are easy to access and in one central place or kit.
Ensure patient is monitored by staff at all times.
Be cautious of dismissing concerns of the patient or family members
All hospital staff should be knowledgeable about signs of possible labor complications
Recommendations from the Maternal Mortality Review Committees
When a woman arrives at the hospital in labor, ensure that the extent of care she needs is accurately established
Establish and disseminate clear policies regarding prevention initiatives
Enforce policies and procedures related to obstetric hemorrhage;
Improve policies related to patient management, including instructions for reducing the rate of Caesarean deliveries, and identify providers who are not following best practices