Postpartum care
Since pregnancy complications may affect women for as long as a year after delivery, pediatricians and pediatric nurses can be an important lifeline for mothers needing postpartum care. Infant check-ups are an opportune time for staff to ask mothers how they are feeling and listen and observe carefully to identify urgent maternal warning signs.
Dr. Rachel Sinkey
While physicians often feel inundated by awareness campaigns, this is one that Rachel Sinkey, MD, of the department of obstetrics and gynecology and division of maternal-fetal medicine at the University of Alabama at Birmingham, wants to see remain top of mind. “It’s an excellent campaign. It’s spot on,” she said in an interview.
“The understanding that the U.S. has the highest maternal mortality rate in the developed world has rightly gained a lot of media attention,” she said. “The death of a mother affects the child, the family, and the entire community. Maternal death is a marker of the health of the community.”
Dr. Sinkey has seen mothers die postpartum of infection and heart problems. Self-harm, psychiatric disorders, and opioid overdoses are also leading causes of maternal death in Alabama. “If we can recognize these mothers and get them into good care, we can reduce some of the overdose deaths,” she said. Unfortunately, however, it’s not always a simple matter of timely recognition and referral, she said. “Some patients don’t have the insurance coverage they need to get access to care.”
Nonobstetric settings
Beyond the context of maternity-specific care, other medical professionals can help, the CDC said. Emergency department staff, paramedics, urgent care staff, primary care providers, and mental health professionals can all ask women about their recent pregnancy status and recognize the signs and symptoms of pregnancy-related complications. Health care professionals should specifically ask patients if they are pregnant or were pregnant in the past year, the CDC advised.
Support materials
Campaign materials available from the website include posters, palm cards, graphics, and social media content in English and Spanish as well as other languages ranging from Arabic to Tagalog and Vietnamese. There are separate guides to help mothers recognize warning signs and comfortably raise issues with their health care providers, as well as guides for providers to ensure respectful listening followed by appropriate action and for women’s partners and family members. A graphic poster, “Pregnant now or within the last year?” clearly illustrates symptoms worth discussing.
The site also connects health care professionals with clinical resources and tools from a variety of complementary stakeholder organizations.
The CDC is partnering in this effort with ACOG and many other medical organizations from the American Academy of Family Physicians and the American Society of Addiction Medicine to the Society for Maternal-Fetal Medicine. The goal is to expand readiness across multiple health care settings to manage obstetric emergencies during pregnancy and the postpartum period.
ACOG’s initiative is called Commitment to Action: Eliminating Preventable Maternal Mortality.
Dr. Sinkey had no competing interests with regard to her comments. Dr. Galang, as a government employee, had no conflicts of interest.