Purpose for the program:  In the United States, 2-3 women die every day due to pregnancy-related complications.The three leading causes of maternal death nationally are: eclampsia/pre-eclampsia, embolism, and hemorrhage.Of these causes, obstetric hemorrhage is known as the most preventable cause of maternal mortality (World Health Report 2007). It is important to study maternal mortality and morbidity two reasons: First, evidence suggests that at least half of pregnancy-related deaths may be preventable through changes in patient, provider, or system factors; and second, mortality rates are disproportionately high among certain racial and ethnic groups. In addition, deaths are only the tip of the iceberg: maternal morbidity also represents a huge burden of disease for women and their families.

Proposed change: The Illinois Department of Public Health (IDPH) Maternal Mortality Review Committee (MMRC) reviewed fifty-two cases of maternal death between the years 2001-2006.Of those fifty-two cases, thirty-eight percent (n=20) of the maternal deaths were due to hemorrhage.The MMRC found that the majority of mortality cases occurred while women were hospitalized.  The Obstetric Hemorrhage Education Project (OHEP) (2009) is a response to the MMRC’s past and continued findings of a leading cause of maternal morbidity and mortality in Illinois being hemorrhage related and preventable. Developed by the Obstetric Hemorrhage Education Project (OHEP) Workgroup, the goal of this educational program is to reduce maternal morbidity and mortality due to obstetric hemorrhage in all birthing hospitals within the state.  The program emphasizes a multidisciplinary approach requiring all providers (MD, RN, CNM, Anesthesia and Residents) to attend education.  The educational requirements of each provider included the completion of a pre and post-program Benchmark Assessment Validation, Didactic presentation, Skill station and Simulation drill. 

Implementation, outcomes and evaluation: The outcomes for this project were analyzed and confirm that this type of program is initially very beneficial.  Maternal mortality in the United States remains a pressing issue for multiple reason, the simplest and perhaps most important of which is the reality of an infant and child without a mother, and the consequences for the family as a whole. 

Implications for nursing practice: Improving maternal mortality involves a committed and long lasting effort on behalf of many individuals along with medical and social organizations to better appreciate the scope of and risk associated with maternal mortality.  Discovery of nursing practices that will reduce morbidity and mortality are discussed.  

Keywords: Obstetric Hemorrhage, Maternal Mortality