Making maternal health a positive outlier

Contemporary OB/GYN Journal, Vol 66 No 10, Volume 66, Issue 10

In the United States, maternal mortality is an outlier, and you may understand better what this means if you have read Malcolm Gladwell’s Outliers: The Story of Success.

In the United States, maternal mortality is an outlier, and you may understand better what this means if you have read Malcolm Gladwell’s Outliers: The Story of Success.1 The book covers outlier success stories, such as The Beatles, Steve Jobs, and Bill Gates, but it also addresses negative outliers. When it came to a spate of plane crashes that had plagued Korean Air, what was the underlying issue?

The numbers are there for us to see why maternal mortality in the United States is an outlier. In his article, Larry Veltman, MD, details some of the numbers and addresses the need for a stronger model of collaborative care and a culture of perinatal safety. He discusses several areas in which systems can improve, including strengthening the “speak up climate” of each perinatal unit.

Korean Air ended up being a success story, after it addressed cultural underpinnings that were leading to the plane crashes. One of those was “cockpit culture,” and the communication it allowed or did not. When planes crash, it is human nature to want to blame the individual pilot or someone else who was in charge, perhaps even an air traffic controller, but it’s a complex organizational structure that inevitably lets a plane take off, fly safely, and make those safe landings. When a mother dies, it is tempting to do the same. Who should get the blame?

On September 15, 2021, the U.S. Commission on Civil Rights released its report “Racial Disparities in Maternal Health,” which examined the federal role in addressing such disparities in maternal health, including negative pregnancy-related health outcomes and pregnancy-related deaths of women in the United States.2

“At the federal level, efforts can be made to improve hospital quality, particularly for women of color if maternal health disparities are to be eliminated,” said Norma V. Cantú, chair of the US Commission on Civil Rights, in a news release. “Improvements in safety culture are linked with improved maternal health outcomes. One recommendation for improving safety in maternal health care is to implement standardized care practices across hospitals and health systems and to standardize data collection systems.”

When we delve deeper into the maternal mortality rate in the United States, we know there are many subcultures at play in this complex world of health care: the health care system itself, training culture, individual cultures of hospitals, the dynamics between health care staff within a given hospital environment, and the patients themselves. Obstetricians and other health care professionals want answers and seek to understand how to improve outcomes.

Korean Air ended up being a success story, after it addressed cultural underpinnings that were leading to the plane crashes. We look to the future to improve these outcomes and seek insight from you as you practice for how this matter can be effectively addressed. Please email us at cogeditorial@mmhgroup.com. We all want to push maternal health outcomes to become a positive outlier.

Mike Hennessy Sr

Chairman and Founder, MJH Life Sciences™

References

1. Gladwell, M. Outliers: The Story of Success. Little, Brown & Company; 2008.

2. US Commission on Civil Rights releases report: Racial Disparities in Maternal Health. News Release. US Commission on Civil Rights. September 15, 2021. Accessed

September 16, 2021. https://www.usccr.gov/fi les/2021/09-15-Press-Release-Maternal-Health-Report.pdf