HOW CALIFORNIA IS SAVING LIVES

As maternal death rates have risen around the country, California— where 500,000 babies are born every year, more than in any other state—has had some dramatic success in lowering them. Death rates there were 15 per 100,000 live births in 2014, compared with the U.S. average of 24 per 100,000.

The reason, according to health experts, is that California has created ready-made tool kits covering the most common maternal-care emergencies, including vaginal hemorrhaging and cesarean section. The kits are designed to teach doctors and nurses how to react quickly, and they are clearly working. Hospitals that began using the tool kit for targeted obstetric bleeding saw a 21 percent decrease in near deaths in the first year.

The preeclampsia tool kit contains a slide show of the most common signs of the condition, a collection of articles on treating high blood pressure (the most dangerous result of preeclampsia), and charts that help medical teams assess how a patient’s vital signs compare with those of women who have suffered from preeclampsia.

Most important, it highlights the need for treating high blood pressure aggressively with antihypertensive medications and prescribing magnesium sulfate as needed.

The kits are created at the California Maternal Quality Care Collaborative (CMQCC), founded in 2007 by Elliott Main, a professor of obstetrics and gynecology at Stanford University and the University of California, San Francisco. Experts at CMQCC analyzed maternal deaths over several years and discovered that in most cases, there was some chance to alter the outcome.

The most preventable deaths were from hemorrhage (70 percent) and preeclampsia (60 percent).