A glamorous Serena Williams landed on the cover of the February issue of Vogue, holding her newborn daughter and wearing a fire engine red gown. Inside the issue, along with the story of her celebrity friendships and tennis ambitions, Williams described the six horrifying days that followed the birth of her child.
The day after her Cesarean section, Williams, who has a history of blood clots, started to have trouble breathing. She recognized the signs and thought she was having a pulmonary embolism. She told the medical staff she needed an immediate CT scan and IV anticoagulant. But according to the article, the nurse thought her pain medicine might be making her confused. Instead, the medical team performed an ultrasound of her legs, which revealed nothing. Only later did the team scan her lungs and find life-threatening blood clots.
I thought of Williams’ frightening experience as New Jersey became the first state to designate a Maternal Health Awareness Day, which will be every January 23. The Tara Hansen Foundation drove the designation and along with Rutgers’ Robert Wood Johnson Medical School (RWJMS) and the American Congress of Obstetricians and Gynecologists, created a safety campaign, “Stop, Look and Listen!” The campaign emphasizes the need for health care personnel to truly listen to the concerns of new mothers. Doing so is simple, yet fundamental, to quality, patient-centered care.
If Serena Williams, an international celebrity and one of the greatest athletes ever, is not heard, what does that mean for your average new mom?
Maternal deaths are not a thing of the past. Maternal deaths in the U.S. exceed other industrialized nations, and New Jersey ranks 35th among states. In New Jersey, we also have significant racial disparities.
None of this is acceptable in 2018. Especially when patients have more information than ever and should be part of the team making sure care is appropriate and timely.
At the Quality Institute, we’re working to improve outcomes for both mothers and babies. One initiative examines the best practices at hospitals with low Cesarean section rates. The work, in partnership with the Greater Newark Healthcare Coalition, is supported by the Horizon Foundation for New Jersey. We’re meeting with high performing New Jersey hospital obstetrical teams to identify their best practices to reduce unnecessary Cesarean deliveries.
Our findings, so far, show the value of strong hospital leadership and good communications: identifying patients’ social needs; talking to patients from the beginning of their pregnancy about vaginal delivery after Cesarean; team huddles before all C-sections to discuss the need; regular clinical staff meetings to go over all C-sections after the fact; sharing performance data with physicians in the spirit of quality improvement; and listening closely to women. All these actions, fostered through constant communication, result from hospital leadership making maternal health a priority.
Improving maternal and infant health is not about discovering new drugs or advancing new technology. We need strong hospital leadership, collaborative approaches with physicians and nurses, and empowered patients.
We can — we must — do better for our state’s newest mothers and the children who need them.