Obstetric violence is an issue of global scope and magnitude. Its widespread and continued presence indicates cultural tolerance enabled by policies and procedures that uphold paternalism. Labor and delivery nurses are the health care professionals who spend the most time at the point of care during birth, and their role must be examined. As active bystanders, labor and delivery nurses are uniquely positioned to prevent or perpetuate obstetric violence during labor and birth. Reflection on the nurse role is necessary to provide optimal care, enhance relationships with patients, and continue to evolve as a professional discipline. Perinatal nurses must lead the change to trauma-informed care practices to mitigate obstetric violence and reduce birth trauma.

Article describing the creation of the PNQIN Equity Bundle Measures.

Referenced in 5/18/22 Equity Webinar.

Referenced in 5/18/22 Equity Webinar

Referenced in 5/18/22 Equity Webinar

Referred to in 4/18/22 Equity Webinar. The objective of this study was to evaluate the impact of quality improvement (QI) and patient safety initiatives and data disaggregation on racial disparities in severe maternal morbidity from hemorrhage (SMM-H).

Management of the patent ductus arteriosus (PDA) is one of the most contentious topics in the care of preterm infants. PDA management can be broadly divided into prophylactic and symptomatic therapy. Prophylaxis with intravenous indomethacin in extremely low birth weight infants may reduce severe intraventricular hemorrhage. Echocardiography should be routinely used to confirm the presence of a PDA before considering symptomatic therapy. A symptomatic PDA can be managed conservatively, using pharmacotherapy or with procedural closure. Ibuprofen should be considered as the pharmacotherapy of choice for a symptomatic PDA. High-dose ibuprofen may be preferable, especially for preterm infants beyond the first 3 to 5 days of age. If pharmacotherapy fails (after two courses) or is contraindicated, procedural closure may be considered for infants with a persistent PDA with significant clinical symptoms in addition to echocardiographic signs of a large PDA shunt volume and pulmonary over-circulation.

Referenced in 10/27/22 Equity Webinar.

TeamBirth Implementation.

Referenced in 10/18/22 Equity Webinar.

TeamBirth Design & Outcomes.

Referenced in 9/27 Equity Webinar.

Key Findings:

Among pregnancy-related deaths with information on timing, 22% of deaths occurred during pregnancy, 25% occurred on the day of delivery or within 7 days after, and 53% occurred between 7 days to 1 year after pregnancy.

The leading underlying causes of pregnancy-related death include:

  • Mental health conditions (including deaths to suicide and overdose/poisoning related to substance use disorder) (23%)
  • Excessive bleeding (hemorrhage) (14%)
  • Cardiac and coronary conditions (relating to the heart) (13%)
  • Infection (9%)
  • Thrombotic embolism (a type of blood clot) (9%)
  • Cardiomyopathy (a disease of the heart muscle) (9%)
  • Hypertensive disorders of pregnancy (relating to high blood pressure) (7%)

The leading underlying cause of death varied by race and ethnicity. Cardiac and coronary conditions were the leading underlying cause of pregnancy-related deaths among non-Hispanic Black people, mental health conditions were the leading underlying cause for Hispanic and non-Hispanic White people, and hemorrhage was the leading underlying cause for non-Hispanic Asian people.