How we can improve maternal healthcare -- before, during and after pregnancy | Elizabeth Howell

The first paragraph describes a harrowing scene where a resident physician arrives at the labor and delivery unit to find a patient in critical condition. The patient, who had just delivered a healthy baby, suffered from shock and uncontrolled uterine bleeding, leading to her death despite the best efforts of the medical team. The physician reflects on the emotional impact of the incident, particularly on the father, and the alarming rate of maternal mortality in the United States. It is highlighted that the U.S. has a higher maternal mortality rate than other high-income countries, with a disproportionate impact on women of color. The physician also shares her personal experience as a new mother and her decision to focus her career on improving maternal health care. The major causes of maternal mortality are outlined, and the concept of severe maternal morbidity is introduced, emphasizing that many of these incidents are preventable with the right protocols and attention to quality care.

The second paragraph discusses the success stories and the implementation of standard care practices through the Alliance for Innovation in Maternal Health (AIM) program. This program, a collaboration between the American College of Obstetricians and Gynecologists, healthcare organizations, researchers, and community groups, aims to reduce maternal mortality and severe maternal morbidity rates. The AIM program has developed safety bundles that target preventable causes of maternal death, which include evidence-based practices, protocols, and necessary equipment. The paragraph also provides an example of a hemorrhage bundle and its components, and notes the significant reduction in near-death cases from hemorrhage in Californian hospitals that adopted the bundle. However, the use of these bundles is inconsistent across the country, and there are stark disparities in care for women of color, particularly Black women, who are three to four times more likely to suffer a pregnancy-related death than white women, regardless of socioeconomic status.

The third paragraph delves into the disparities in maternal health care in the United States, particularly focusing on the experiences of Black women. It discusses the tendency of Black women to deliver in hospitals with worse outcomes and the impact of these disparities on maternal mortality and severe maternal morbidity rates. The paragraph highlights the need to address the social determinants of health but also emphasizes the immediate action that can be taken to improve the quality of care. It outlines the importance of providing high-quality care across the entire care continuum, from contraception and preconception care to prenatal, delivery, postpartum, and inter-pregnancy care. The story of Maria, a woman who received attentive care during her high-risk pregnancy and successful delivery, illustrates the difference that quality care can make. The paragraph concludes with a call to action, urging society to value the lives of pregnant women from every community and to prepare the necessary tools and evidence base to improve maternal health care.

The final paragraph is a brief closing remark that thanks the audience for their attention, followed by applause. It serves as a conclusion to the speaker's presentation on maternal health care disparities and the urgent need for quality care improvements.