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Safety for Mothers Comes First at BCH

December 10, 2019

Ensuring a safe delivery for every patient is the top priority for all the providers and staff at the Boone County Hospital (BCH) Family Birth Center. Recently, national and local news outlets have shared stories about the alarming rates of maternal mortality in the United States. The Centers for Disease Control (CDC) states three in five pregnancy related deaths could be prevented. Not all of the deaths occur while the patient is in the hospital. According to the CDC, about 31% of deaths occur during the pregnancy, 36% occur from delivery to one week postpartum, and 33% occur one week to one year postpartum. The leading causes of death differ throughout the pregnancy and after. Some of the most common direct causes are related to severe bleeding, amniotic fluid embolism, hypertension (high blood pressure) disorders of pregnancy, infection, and cardiomyopathy (weakened heart muscle). Heart disease and stroke cause the most deaths overall. BCH providers and staff have taken steps to ensure patients are cared for in a safe environment and leave the hospital with the correct information to know when to call for help.

Infection or sepsis attributed to 12.4% of maternal deaths in the U.S. between 2011-2015 (CDC, June 4, 2019). Staff assess all patients, including delivering mothers, for signs and symptoms of sepsis on admission and then regularly throughout their hospitalization. If a patient is found to be at risk for sepsis there is a standardized protocol in place that staff and physicians follow to ensure timely treatment and intervention.

Hemorrhage or severe bleeding after delivery can be a real concern for patients and attributes to 11.2% of maternal deaths (CDC, June 4, 2019). The Family Birth Center and Surgical Services staff have measures in place to ensure any excessive bleeding is recognized and intervention occurs immediately. All delivering patients have an assessment completed to determine their risk for bleeding at the time of admission and then regularly throughout their stay. If the patient is determined to be at risk, additional lab work and blood preparation will occur in the event of an emergency. At the time of delivery, nurses complete an accurate measurement on any blood loss to ensure they are aware and ready to intervene before the situation becomes an emergency. There is also an emergency hemorrhage cart at every delivery with the needed supplies should the situation escalate and further intervention is needed.

Hypertension disorders of pregnancy complicate up to 10% of pregnancies worldwide (ACOG, 2013) and account for 6.8% of maternal deaths according to the CDC (June 4, 2019). The Family Birth Center staff ensures all patients are aware of the signs and symptoms of concern both during the pregnancy and when patients are leaving after delivery. There is a standardized protocol that is followed by all providers at BCH to ensure timely intervention and treatment of all maternity patients with severe hypertension.

Post birth warning signs are provided to all patients and their support person to ensure they are aware of the signs and symptoms of concern after patients leave the hospital and the urgency in which the symptom needs to be addressed. Nurses review pulmonary embolism, cardiac disease, hypertensive disorders of pregnancy, obstetric hemorrhage, venous thromboembolism, infection, postpartum depression, and the importance of follow up of with their provider. The education is organized in an easy to remember acronym of POST BIRTH to help patients remember and a magnet for easy reference is provided. 

The Family Birth Center providers and staff continually work to improve care and services that we provide to our patients and community. We are excited to care for you and your loved ones during a very exciting time in life and want to assure you that we are providing you with care that is safe and personal. Please call (515) 433-8400 if you are interested in a tour of the BCH Family Birth Center or would like to speak to a nurse regarding educational opportunities during your pregnancy.

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