According to a study of postpartum nurses, the knowledge of this group of healthcare workers is far from adequate regarding maternal morbidity and mortality. The study appears in MCN: The American Journal of Maternal/Child Nursing and shows this alarming trend.
The team of researchers looked at 372 nurses who provide postpartum care to mothers who have just given birth. As low as 15 percent of the nurses who participated in the study were aware of the current U.S. rate of maternal mortality.
Maternal mortality is the number of maternal deaths during childbirth for every 1000 live born babies. It is an indicator of good prenatal (before birth or during pregnancy), intra-partum (during birth) and post partum (after birth) care. An estimated 700 to 900 women die in the U.S. every year from pregnancy or childbirth related causes. In recent years the maternal mortality in the U.S. has risen. However among the respondents in this study, 19% thought the maternal mortality rates have reduced in the recent times.
Only 12 percent of the respondents knew that most of the deaths in the mothers occur within days and weeks after delivery. Less than a quarter of the participants (24 percent) knew that heart-related problems were the leading cause of maternal death in the U.S.
According to study co-author Debra Bingham, who heads the Institute for Perinatal Quality Improvement and teaches at the University of Maryland School of Nursing, if the nurses did not know about the rise in maternal mortality rates, they would not take it as an urgent responsibility to explain to women about the warning signs.
Among the participants, majority – 88 percent could not identify the leading causes of maternal deaths and most of the nurses – 67 percent – spent less than 10 minutes with the mothers as they were discharged from the hospital to look for “potential warning signs”. This was despite the fact that most of them – 95 percent – agreed that there was an association between postpartum education and maternal deaths. Only 72% agreed however that providing this education to the mothers was their responsibility. Nurses over the ages of 40 were found to be more likely to believe they were competent to provide such education regarding postpartum complications and warning signs to the mothers as they were discharged from the hospital.
According to lead researcher Patricia Suplee, an associate professor at the Rutgers University School of Nursing in Camden, N.J., heart diseases and heart failures were the leading causes of maternal deaths and most nurses were least comfortable or confident explaining about the warning signs of these conditions to the mothers.
The researchers wrote that most of the nurses surveyed did not know the background maternal mortality rates and also did not provide the “comprehensive education” they were supposed to provide mothers as they were discharged from the hospitals. This lack of education could be contributing to the mothers’ unawareness regarding potential warning signs of complications and this increases chances of morbidity and even mortality after childbirth.
Study authors have emphasized the importance of post delivery education. This is because once the mother is discharged from the hospital, she typically would not see a healthcare professional for four to six weeks. Further around 40 percent of the new mothers due to lack of child care support or child care maternity leaves or other kinds of support, never go back to the healthcare set up after childbirth. This means that the education that the nurses would provide to the mothers at discharge becomes their last contact of sorts with a healthcare professional. Not knowing the warning signs would be thus dangerous.
According to the Centers for Disease Control and Prevention 65,000 women annually in the United States face some or the other complications after childbirth including heart attacks and bleeding. Black women and those residing in rural areas are at greater risks. The rate of severe maternal morbidity (SMM) reportedly doubled over the past decade. A latest CDC Foundation analysis of data from four states has shown that nearly 60 percent of maternal deaths could be prevented.
Study authors concluded that all nurses should be brought up to speed to themselves understand the potential warning signs and educate the mothers regarding the same to ultimately bring about a reduction in the maternal deaths as well as reducing the severity of the complications in the mothers after childbirth.