UNC Collaborative for Maternal & Infant Health

UNC Collaborative for Maternal & Infant Health

Improving the health of North Carolina's women and infants

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ERASE Maternal Mortality

March 8, 2023 by Megan Canady

CDC. ERASE Image, 19 Sept. 2022, www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/index.html.

The ERASE MM (Enhancing Reviews and Surveillance to Eliminate Maternal Mortality) initiative assists states in identifying ways to reduce maternal mortality and complications of pregnancy.

Our CMIH team collaborates with North Carolina hospitals, clinics, and communities to provide free training on maternal warning signs during pregnancy and 1 year postpartum to provide assistance with planning and implementation of obstetric emergency protocols.

‘I Gave Birth’ Implementation Tool Kit

Approximately 2 out of 3 pregnancy-related deaths occur outside of the day of delivery or the week postpartum

Pregnancy-Related Mortality in the United States, 2011-2013. http://www.ncbi.nlm.nih.gov/pubmed/28697109

The goal of the “I Gave Birth” bracelet initiatives to improve care of patients who present for medical care during the postpartum period. The bracelets serve as a reminder to staff to look for post-birth warning signs including:

  • Chest pain or shortness of breath
  • Seizures or headache
  • Thoughts of harming themselves or others
  • Uncontrollable bleeding
  • Fever of 100.4 F or higher

Bracelets are provided to patients delivering a live infant or stillbirth after 20 weeks gestation along with education about post-birth warning signs.

Image of 'I Gave Birth' Bracelet
Image of ‘I gave birth’ bracelet
Click here for a step-by-step plan for implementing this initiative in your institution!

For more resources and printable handouts

  • AIM Statement Worksheet 
  • IHI—QI Essentials Toolkit: Maternal Health 
  • IHI—Science of Improvement: Forming the Team  
  • Quality Improvement Project Measures Worksheet
See how this was initiated with ECU Health Medical Center

ECU Health Medical Center is the only tertiary care center in Perinatal Region VI; they were influential in allocating best practices and quality improvement initiatives. Below you will see the presentation overview with background, methods, and discussions surrounding the ‘I Gave birth’ initiative. Informational flyer and badge ID cards are included below, serving as a visual reminder of the initiative and care in the 4th trimester.

Rack Card used at Prenatal Care offices and Obstetrical units for Provider and Patient awareness
Badge cards created as a reference for patients
during the 4th trimester
Source: Quick reference badge card created by
Lauren Robertson, MS4 and Erika Booth, MS4

References

‌AWHONN. POST-BIRTH Warning Signs education program (n.d.).  https://www.awhonn.org/education/hospital-products/post-birth-warning-signs-education-program/ 

CDC. (2016, January 1). CDC Newsroom: Hear Her: CDC campaign highlights Warning Signs of Pregnancy https://www.cdc.gov/media/releases/2022/p0919-pregnancy-related-deaths.html 

Noble BSN, RNC, J., Harper MSN, RN, MHA, K. D., Mitchell MSN, CNM, K., & McClain MA, MPH, E. K.(2023). “I Gave Birth”–An Initiative to Improve Postpartum Care [Review of “I Gave Birth”–An Initiative to Improve Postpartum Care]. North Carolina Medical Journal, 4(1), 24–27. 

Roosa Tikkanen et al. (2020, November 18). Maternal mortality and maternity care in the United States compared to 10 other developed countries. https://doi.org/10.26099/411v-9255 

Additional Patient Education Resources

Click on the ‘Order Materials’ button below to order free educational materials through the DHHS Warehouse

Order Materials
AWHONN PBWS & Maternal Warning Signs Education and Training

UNC Collaborative for Maternal & Infant Health has the ability to serve birthing facilities across North Carolina by providing training and technical assistance.

AWHONN Post Birth Warning Signs Training

AWHONN Post Birth Warning Signs online seats is an offered course available through the AWHONN Learning Center. These codes are made possible by funding received for ERASE MM. During our 4th grant year, UNC CMIH will be working with eight (8) facilities to implement the AWHONN Post Birth Warning Signs (PBWS) toolkit and training.

If you are interested in being one of these 8 facilities, please reach out to Liz Soto at: lizso@email.unc.edu

Maternal Warning Signs Training

Maternal Warning Signs training incorporates content developed by the CDC Urgent Maternal Warning Signs campaign into a one-hour long training that can be tailored to meet the needs of the target audience.  

Maternal Warning Signs Target Audience: doctors, residents, nurses, emergency personnel, doulas, lactation consultants, and childbirth educators 

Training is available as instructor-led or eLearning.  

Additional Resources
  • Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM) | CDC 
  • NC Maternal Mortality Review Report (ncdhhs.gov) 
  • Urgent Maternal Warning Signs | AIM (saferbirth.org) 
  • Urgent Maternal Warning Signs | CDC 
  • “HEAR HER Campaign | CDC www.cdc.gov/hearher/index.html 
Contact Us ✉ Liz Soto BSN, RN | lizso@email.unc.edu
DISCLAIMER: This webpage was supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $450,000 with 0% percentage financed with nongovernmental sources. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement, by CDC, HHS, or the U.S. Government.   

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Filed Under: Uncategorized Tagged With: Bracelets, ERASE, i gave birth

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ERASE Maternal Mortality (“I Gave Birth” Initiative)

https://www.mombaby.org/2023/erase-maternal-mortality/

UNC Collaborative for Maternal and Infant Health aims to improve the health and well-being of women and families across North Carolina through community partnerships, research and clinical care innovations, and developing new approaches to complex problems.

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