Global maternal mortality rate declines

American Academy of Nursing

Presidents Message

Global maternal mortality rate declinesExcept

in America 

The broad topics I will address this issue fall under Reproductive Rights and our value of social justice. The Academy stated mission and vision on policy and advocacy work is based on using the best available sci- entific evidence. This allows us to lend objectivity to complex, emotionally charged issues, such as mater- nal morbidity and mortality. It is out of that weighted objectivity that valid recommendations for modifying clinical practice can come. I will cite the negative con- sequences that occur when the available evidence is not consistently embedded in practice. This message illustrates the negative consequences

when clinical providers, health systems, and payers do not utilize these evidence-based practices. The specific concern is the alarmingly high rate of maternal mor- tality and morbidity in the United States. Each year in America, 50,000 women suffer life-threatening compli- cations (Young, 2018) and 700 of those die (The Editorial Board, 2018) from a natural event that has been going on since the beginning of timechild- birth. If those facts do not shock you, they should, especially when you consider that more than half of these deaths are preventable. The majority of maternal deaths in the United States

are attributed to hypertension and excessive blood loss. Implementing safety procedures that have been known to the health care profession for decades could prevent them. For example, closely monitoring high blood pressure and blood loss are just two low tech and low cost interventions that can alert nurses and physicians when a new mother is on a potential path of becoming seriously ill (Young, 2018). The steadily rising maternal death rate in the

United States is now 26.4% per 100,000 births. (The Editorial Board, 2016) This statistic counters a global trend which shows maternal mortality rates dropping in the developed world. (Tavernise, 2016) Between 1990 and 2015, the number of maternal deaths in Germany, France, Japan, England, and Can- ada, has been flat or has declined. (The Editorial Board, 2016) All the while, the rate in the United States, which boasts one of the most advanced health care systems in the world, sees maternal mor- bidity and mortality climbing. In America, maternal deaths suffered by women of color are the key factor driving the increase. (Lost mothers: Maternal mortal- ity rates in the U.S., 2018) In New York City, home of the countrys largest

blackwhite disparity in the maternal death rate, the

divide is getting larger. This widening gap is particu- larly troublesome considering the fact that the citys overall maternal mortality rate has gone down. (Wald- man, 2018) Black women in New York City face a higher rate of harm than their white counterparts even when they are college educated, have a normal weight and are affluent. In fact, black women from the citys wealthiest neighborhoods have poorer maternal outcomes than white, Asian, and Hispanic mothers from the citys poorest areas. (Waldman, 2018) New York City has recently funded $12.8 million to

underwrite an initiative to eliminate the blackwhite disparity in maternal deaths in that city. (Wald- man, 2018) The money will be used to improve data collection specific to pregnancy- and childbirth-related deaths, pay for implicit bias training for medical staff at private and public facilities and underwrite a city- wide awareness campaign for the public. In addition, the city has taken steps to improve maternal care in its owned hospitals by offering specific training on how to identify and treat two of the most frequent causes of maternal deathhemorrhaging and blood clots. Another program innovation, the introduction of maternal care coordinators, will target high-risk moth- ers-to-be with additional assistance to navigate preg- nancy, prescriptions and public health benefits. The goal of this comprehensive effort is to reduce by half the number of pregnancy- and childbirth-related com- plications occurring in New York City during the next five years. This quality improvement pilot program came on the

heels of an NPR series entitled lost mothers: maternal mortality rates in the U.S. (Waldman, 2018) The series focused on pregnant patients high hemorrhage rates in a Brooklyn hospital. Only California, which has implemented many of the

gold standard practices outlined in the Alliance for Innovation in Maternal Health Program (AIM), (Alliance for Innovation in Maternal Health) is the exception to this startling trend. AIM is a data-driven national safety and quality improvement program designed specifically to address issues related to maternal health. AIM safety bundles, an evidence- based list of quality-oriented practices and checklists, helped California bring down maternal complication rates 21% in just 24 months. As a result of implement- ing this quality improvement methodology designed to tackle the most common problems in childbirth, including heart attack, kidney failure, and blood clots,



N u r s O u t l o o k 6 6 ( 2 0 1 8 ) 4 2 8 4 2 9 429

significantly fewer California women found them- selves on ventilators or scheduled for a hysterectomy after giving birth. (Young, 2018) While New York City and California are stepping up

to address maternal mortality in the short term, sev- eral other states have established review committees to investigate the issue, and the U.S. Senate has pro- posed legislature to provide $50 million in funding to reduce maternal mortality. (Waldman, 2018) In late August, Senator Kamala Harris (D-CA) introduced the Maternal Care Access and Reducing Emergencies (CARE) Act. The Care Access and Reducing Emergen- cies Act is aimed at addressing and reducing the disproportionate rates of maternal mortality and life-threatening pregnancy complications for African- American women in the United States. With a focus on addressing the racial disparities in maternal mor- tality, the bill would establish:

Implicit bias training grants directed to medical schools, nursing schools, and other training pro- grams for health care providers to support implicit bias training.

Pregnancy medical home grants directed to up to 10 states to establish or operate statewide pregnancy medical home programs. The pregnancy medical home model incentivizes maternal health care pro- viders to deliver integrated health care services to pregnant women and new mothers, with the aim of reducing adverse maternal health outcomes, mater- nal deaths, and racial health disparities in maternal mortality.

These alarming maternal morbidity and mortality rates point out the importance of science and evidence in shaping public safety advocacy. Using data and research to validate best practices helps health care providers minimize unnecessary care, save money, and move patients into appropriate pathways that pro- duce desired results. (Carroll, 2017) However, statisti- cal significance and clinical significance are not the same. With a substantial cohort, statistical signifi- cance can be achieved but simply having a large sam- ple does not necessarily create the clinical significance needed to modify clinical practice. (Carroll, 2017) Knowledge gleaned from data and research calls out for a real-world perspective against which it can be evaluated and acted upon. Health systems, nurses, providers and insurers

appear unable to hardwire the evidence of safety practices related to managing hypertension and blood loss in a highly reliable way. This is an oppor- tunity for nurse leaders to advocate for change based on this evidence. The need to advocate is now. The time for studying maternal mortality has

long since passed. Without our leadership, America will continue to be the most dangerous place in the developed world to give birth.


Alliance for Innovation in Maternal Health. New York Times. Available online from https://safehealthcarefore

Carroll, A. (2017). What we mean when we say evidence- based medicine. New York Times. Available online from we-mean-when-we-say-evidence-based-medicine. html.

Lost mothers: Maternal mortality rates in the U.S. (2018). ProPublica and National Public Radio. Available online from mothers.

Tavernise, S. (2016). Maternal mortality rate in U.S. rises, defying global trend, study finds. New York Times. Available online from 09/22/health/maternal-mortality.html.

The Editorial Board. (2016). Global Burden of Disease Study 2015 provides GPS for global health 2030. The Lancet. Available online from 6736(16)31743-3.

The Editorial Board. (2018). High maternal death rate shames America among developed nations. USA Today. Available online from story/opinion/2018/07/31/high-maternal-death-rate- shames-america-developed-nations-editorials- debates/866752002/.

Waldman, A. (2018). New York City launches initiative to eliminate racial disparities in maternal death. Propubl- ica. Available online from article/new-york-city-launches-initiative-to-elimi nate-racial-disparities-in-maternal-death.

Young, A. (2018). Hospitals know how to protect mothers. They just arent doing it. USA Today. Available online from tigations/deadly-deliveries/2018/07/26/maternal-mor tality-rates-preeclampsia-postpartum-hemorrhage- safety/546889002/.

Karen S. Cox, PhD, RN, FACHE, FAAN Nursing Advocacy and Leadership,

Childrens Mercy Hospital, Kansas City, MO

Corresponding author: Karen S. Cox, Childrens Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108.

E-mail address: [email protected]

Available online August 24, 2018

0029-6554/$ see front matter

2018 Published by Elsevier Inc.


  • Global maternal mortality rate declines-Except in America
    • References

Get Professional Assignment Help Cheaply

Buy Custom Essay

Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?

Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.

Why Choose Our Academic Writing Service?

  • Plagiarism free papers
  • Timely delivery
  • Any deadline
  • Skilled, Experienced Native English Writers
  • Subject-relevant academic writer
  • Adherence to paper instructions
  • Ability to tackle bulk assignments
  • Reasonable prices
  • 24/7 Customer Support
  • Get superb grades consistently

Online Academic Help With Different Subjects


Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.


Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.

Computer science

Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!


While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.


Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.


In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.


Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.


We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!


We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.


Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.

What discipline/subjects do you deal in?

We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.

Are your writers competent enough to handle my paper?

Our essay writers are graduates with bachelor's, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.

What if I don’t like the paper?

There is a very low likelihood that you won’t like the paper.

Reasons being:

  • When assigning your order, we match the paper’s discipline with the writer’s field/specialization. Since all our writers are graduates, we match the paper’s subject with the field the writer studied. For instance, if it’s a nursing paper, only a nursing graduate and writer will handle it. Furthermore, all our writers have academic writing experience and top-notch research skills.
  • We have a quality assurance that reviews the paper before it gets to you. As such, we ensure that you get a paper that meets the required standard and will most definitely make the grade.

In the event that you don’t like your paper:

  • The writer will revise the paper up to your pleasing. You have unlimited revisions. You simply need to highlight what specifically you don’t like about the paper, and the writer will make the amendments. The paper will be revised until you are satisfied. Revisions are free of charge
  • We will have a different writer write the paper from scratch.
  • Last resort, if the above does not work, we will refund your money.

Will the professor find out I didn’t write the paper myself?

Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.

What if the paper is plagiarized?

We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.

When will I get my paper?

You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.

Will anyone find out that I used your services?

We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.

How our Assignment  Help Service Works

1.      Place an order

You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.

2.      Pay for the order

Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.

3.      Track the progress

You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.

4.      Download the paper

The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.

smile and order essaysmile and order essay PLACE THIS ORDER OR A SIMILAR ORDER WITH US TODAY AND GET A PERFECT SCORE!!!

order custom essay paper