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.

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IHI’s QI Essentials Toolkit includes the tools and templates you need to launch a successful quality improvement project and manage performance improvement. Each of the ten tools can be used with the Model for Improvement, Lean, or Six Sigma, and includes a short description, instructions, an example, and a blank template.

In 2021, the Illinois Perinatal Quality Collaborative (ILPQC) will launch the statewide obstetric quality improvement initiative, Birth Equity (BE). This is an important statewide quality improvement initiative selected by the Illinois Department of Public Health (IDPH) Statewide Quality Council (SQC) and Perinatal Advisory Committee to engage hospital teams to implement strategies to address maternal health disparities and promote birth equity. Birth equity is the assurance of the conditions of optimal births for all people with a willingness to address racial and social inequities in a sustained effort.

ILPQC will work alongside hospital teams to achieve
this goal through: addressing social determinants of health during prenatal, delivery, and postpartum care; utilizing race/ethnicity medical record and quality data; engaging patients, support partners, and communities with a focus on patient-centered care; and engaging and educating providers, nurses, and staff to improve birth equity.

The following list of resources has been aggregated for those interested in learning more about birth equity. As a part of CMQCC’s Birth Equity Collaborative, participating hospitals have identified the framework and resources below as useful in beginning conversations about birth equity on their units. We at CMQCC are not experts in birth equity, and would like to highlight and amplify the work of the Black-led organizations and leaders who created these resources. Whenever possible, we have hyperlinked to the original source. 

Non-PNQIN Toolkit

Policy Points:

  • There need to be sweeping changes to medical school curricula that addresses structural racism in medicine and how to attend to this in medical practice.
  • The Liaison Committee on Medical Education should develop and promulgate specific learning objectives and curricular offerings that require medical schools to teach about structural racism and antiracist medical practice in ways that are robust and standardized.
  • The federal government, through the Health Resources and Services Administration, should prioritize support for antiracism education in medical schools, residency, and continuing medical education in similar ways and with similar effort in scale and scope to its support for primary care, providing technical assistance and grants for programs across the educational spectrum that provide antiracist training.
  • State governments should mandate, as part of continuing education requirements for physicians, 2 or more hours per recertification cycle of antiracist training.

Exploring Evidence for Disrespect and Abuse in Facility-Based Childbirth