Dr Haywood Brown on the Alliance for Innovation in Maternal Health

Haywood Brown, MD, immediate past president of the American College of Obstetricians and Gynecology, discusses the Alliance for Innovation in Maternal health (AIM) program which is designed to decrease the top-leading causes of maternal morbidity and mortality.

What is the Alliance for Innovation in Maternal health (AIM) and what have the results of the program been thus far?
Well first of all this is targeted towards patient safety. We know, for instance, that some of the major complications of pregnancy are hemorrhage, thromboembolism, and hypertension. So, the alliance on innovation and [maternal health] are geared toward decreasing maternal morbidity and mortality from the top-leading causes for maternal death [that are] obstetric-related. 

But the other thing that we’ve tied into that is [the] safe reduction of cesarean deliveries. Keep in mind that cesarean delivery is more complicated than a vaginal delivery, it’s more risky for all the complications. The safety bundles– if they’re incorporated properly at every single hospital– that will decrease morbidity and mortality. 

So, the idea of every hospital, regardless of its size [and] regardless of its location, having a “hemorrhage bundle” is essential. For us to be able to educate women on the proper follow up when they’ve had preeclampsia, using the guidelines of being seen within 72 hours or certainly 7 days, is that safety bundle. Making sure that we all understand what the risks are with cesarean delivery, and why it’s so important to lower that cesarean delivery rate.

But the other thing that we’ve most recently done is put together a disparity bundle to be attached to all those bundles. Because, as I showed in my slide yesterday, the disparity issue is real, but it’s very complex. And we recognize also that there are biases in the system– for underserved women based on insurance– and it’s really not just racial disparity, it’s economic disparity. I was just sharing that with someone the other day– if you’re poor and white, you still have higher risks because of the biases in the system. 

We have to pay attention to those type of things, and we can’t blame all of the disparity on comorbidities. We have to blame some of it on the biases that we bring to the system and how you treat it, and how you receive in the work place, in the environment, in the clinic, in the office, in the hospital.   
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