The Journal of the Arkansas Medical Society Issue 9 Vol 114 | Page 13

A
C L O S E R
EDUCATE MOTHERS
TO REDUCE PROBLEMS
Education of new mothers and their
family is vital to reduce and prevent
maternal mortality and morbidity.
Moms need to be aware of the many
changes their body goes through
during pregnancy and delivery,
and that there will be discomfort,
soreness and fatigue. However, some
discomforts and warning signs may
need medical attention.
New mothers should be
encouraged to trust their instincts
about their bodies and pay attention
to these warning signs:
• Bleeding that’s heavier than during
normal menstrual period or that
gets worse
• Discharge, pain or redness that
does not go away or gets worse
• Feelings of sadness that last longer
than 10 days after giving birth
• Fever higher than 100.4 F
• Pain or burning when going to
the bathroom
• Pain, swelling and tenderness in
legs, especially the calves
• Red streaks on breasts or painful
lumps in a breast
• Headache that does not get better
after taking medicine or headache
with vision changes
• Severe pain in lower stomach, feel-
ing nauseous or vomiting
• Foul-smelling vaginal discharge
Critical warning signs include:
• Bleeding that can’t be controlled
• Chest pain
• Trouble breathing
• Shortness of breath
• Seizures
• Signs of shock such as chills,
clammy skin, dizziness, fainting or
a racing heart
• Mother has thoughts of hurting
herself and/or the baby
L O O K
AT
Q U A L I T Y
A CLOSER LOOK AT QUALITY
ARKANSAS’ EFFORTS TO
DECREAS E MATERNAL MORTALITY
The University of Arkansas for Med-
ical Sciences (UAMS) Antenatal and
Neonatal Guidelines, Education and
Learning System (ANGELS) and Center
for Distance Health (CDH) hosted
the Perinatal Outcomes Workgroup
by Education and Research (POWER)
networking event in April 2017 for
every Arkansas facility that provides
obstetric services.
The training focused on implement-
ing patient safety bundles for two
leading causes of maternal mortality:
Postpartum Hemorrhage Safety Bun-
dle and Hypertensive Emergencies in
Pregnancy Safety Bundle. Each facility
participating in POWER received com-
ponents of both safety bundles, includ-
ing web addresses of national groups
spearheading the implementation of
safety bundles, supporting literature
and hyperlinks to other supporting
literature. POWER began working with
participating facilities to identify as-
pects of the bundle they already had in
place and the aspects that needed to
be developed. The facilities also identi-
fied potential barriers to safety bundle
implementation. The goal is for every
facility to successfully implement both
safety bundles and assign a staff men-
tor to facilitate the process. Regular
virtual meetings assess progress and
identify areas needing support.
Under the direction of Arkansas
Medicaid, AFMC’s Medicaid Qual-
ity Improvement team will focus
on educating new mothers about
post-birth warning signs specific to
maternal mortality. The focus groups
will include hospital emergency
and obstetric departments, hospital
prenatal classes, OB/GYN providers,
nurses and clinic staff, home visitors
and community health units. Teaching
all women to recognize potentially
life-threatening signs of post-birth
complications can save lives. s
Mrs. Murtha is an AFMC quality manager.
REFERENCES
• Centers for Disease Control and Preven-
tion. Meeting the Challenges of Measur-
ing and Preventing Maternal Mortality
in the United States. Retrieved from
https://www.cdc.gov/cdcgrandrounds/
archives/2017/november2017.html
• Association of Women’s Health, Obstetric
and Neonatal Nurses (AWHONN) Postpar-
tum Discharge Education Program. (2017)
POST-BIRTH Warning Signs: The Nurse’s
Role in Preventing Maternal Morbidity and
Mortality. Retrieved from http://www.
awhonn.org/?page=POSTBIRTH
• Building U.S. Capacity to Review and Pre-
vent Maternal Deaths. (2017). Report from
maternal mortality review committees: a
view into their critical role. Retrieved from
https://www.cdcfoundation.org/sites/de-
fault/files/upload/pdf/MMRIAReport.pdf
• Centers for Disease Control and Preven-
tion. At A Glance 2016: Maternal Health:
Advancing the Health of Mothers in the
21st Century. Atlanta, GA: CDC, Division of
Reproductive Health; 2016. https://www.
cdc.gov/chronicdisease/resources/pub-
lications/aag/pdf/2016/aag-maternal-
health.pdf
• Centers for Disease Control and Pre-
vention. Saving Mothers, Giving Life:
Maternal Mortality. Phase 1 Monitoring
and Evaluation Report. Atlanta, GA: CDC,
U.S. Department of Health and Human
Services; 2014. https://www.savingmoth-
ersgivinglife.org/docs/Maternal_Perina-
tal_Outcomes.pdf
• American College of Obstetricians and
Gynecologists and the Society for Mater-
nal–Fetal Medicine, Kilpatrick SK, Ecker
JL. Severe maternal morbidity: screen-
ing and review . Am J Obstet Gynecol.
2016;215(3):B17–B22. https://www.acog.
org/Resources-And-Publications/Obstet-
ric-Care-Consensus-Series/Severe-Mater-
nal-Morbidity-Screening-and-Review
• American College of Obstetricians and
Gynecologists, Association of Women’s
Health, Obstetric and Neonatal Nurses,
The Joint Commission, Society for
Maternal-Fetal Medicine. Severe maternal
morbidity: clarification of the new Joint
Commission sentinel event policy.
Washington, DC: American College of Ob-
stetricians and Gynecologists, AWHONN,
SMFM; Oakbrook Terrace (IL): Joint Com-
mission; 2015.
NUMBER 9
MARCH 2018 • 205