State targets deaths in labor
New guidelines seek to reduce number of childbirth tragedies
AUSTIN — Hoping to curb the state’s continuing crisis with pregnancy-related deaths, Texas health officials are ramping up efforts to impose new guidelines credited with reducing up to 22 percent the number of mothers dying during childbirth in other states.
Texas became one of 23 states across the country several months ago to join the Alliance for Innovation on Maternal Health, or AIM, a national datadriven program focused on improving the safety and care of pregnant women by partnering with state health departments.
The guidelines come in the form of “bundles,” or standardized sets of plans and instructions that participating hospital staff can use when patients have severe pregnancy complications, such as hemorrhaging or hypertension.
State health officials said the initial five states to join AIM in 2015 — California, Florida, Illinois, Michigan and Oklahoma — saw decreases of 8.3 to 22 percent in severe maternal morbidity after they began using the safety bundles.
“These bundles have been developed to address some of the most common complications and causes of death for women in that period of maternal mortality,” said Dr. Lisa Hollier, president-elect of the American College of Obstetricians and Gynecologists.
Hollier, based in Houston, chairs the state’s Maternal Mortality and Morbidity Task Force, which operates under the Department of State Health Services.
The task force reported in 2016 that 189 mothers died within a year of giving birth in 2011 and 2012. Many of the mothers
died from cardiac events, substance abuse, hypertension and hemorrhaging, among other complications, according to the report.
State health officials recently hosted a webinar with hospitals interested in implementing the AIM guidelines dealing with hemorrhage, hypertension and opioid use. The last bundle is still being developed, state health officials said.
The state hopes to ultimately have the AIM guidelines in use in at least 75 percent of Texas birthing facilities, health officials said.
Ben Taub Hospital, a part of the Harris Health System, was the first hospital in the state to join AIM when it began using the bundle for hemorrhaging in 2016, said Dr. Carey Eppes, chief of obstetrics.
The hospital is also implementing the hypertension bundle, she said.
“(The guidelines) were completely transformative for our labor and delivery, as far as our outcomes and how we interacted and how we communicated and how we reacted to things,” Eppes said.
A state health department spokesperson said the goal of the AIM program is to promote best practices without imposing a one-size-fits-all solution.
“It’s not to say that everyone has to do everything exactly the same; what works well in one hospital may not be what works well in another hospital,” Dr. Christopher Glantz, a New Yorkbased obstetrician-gynecologist, said in the recent webinar. “For the most part, these are guidelines that work. And each hospital certainly needs to review what they’re doing. And if they’re not doing these guidelines, then why is that?”
Hollier said the task force plans to release another report focusing on more recent data this fall, just before the start of next year’s legislative session.