Multi-organization call to action identifies and addresses safety concerns in labor

April 08, 2015

WASHINGTON, April 8, 2015-- A healthcare, industry-first collaborative blueprint for labor and delivery safety, developed by four leading professional organizations in maternal health, calls for improving communication among clinicians, team leaders, administrators, health care providers, organizations, and patients to ensure fewer risks and better outcomes for mothers and babies.

The four collaborating organizations are the American College of Nurse-Midwives; the American College of Obstetricians and Gynecologists; the Association of Women's Health, Obstetric and Neonatal Nurses; and the Society for Maternal-Fetal Medicine. Additionally, these organizations partnered with VitalSmarts, a research and training organization.

The report, "Transforming Communication and Safety Culture in Intrapartum Care: A Multi-organization Blueprint," follows previous research on safety concerns during childbirth and communication among labor and delivery teams. The report appears in the April 7 edition of the Journal of Obstetric, Gynecologic, & Neonatal Nursing and will also appear in the Journal of Midwifery & Women's Health and Obstetrics & Gynecology (The Green Journal).

As a call to action, the Blueprint outlines ways in which individual clinicians, team leaders, administrators, health care providers, organizations and associations, and even patients can use enhanced communication to improve outcomes in labor and delivery.

"The research shows that a lack of speaking up and proper dialogue is a significant problem when it comes to risks during labor and childbirth," said David Maxfield, vice president of research at VitalSmarts and lead researcher on one of the studies and the resulting Blueprint. VitalSmarts, which assisted with the Blueprint, consults with the organizations on the development of training and resources to improve cultures of silence in perinatal care. "Proper communication is essential for labor and delivery teams to respond to rapidly changing and life-threatening events that can occur during the birthing process."

This communication is fundamental to the safety of mothers and babies. The Blueprint points out that the inability of a clinical team to speak up or effectively communicate can have a devastating impact.

Studies suggest that at least 50 percent of maternal morbidity and mortality is in some way preventable. Several organizations have demonstrated that implementation of safety programs are scalable and can be one powerful way to improve safety and patient outcomes.

The Blueprint states, "It takes an expert team and mutual accountability to provide excellent care to women and families. Differences of opinion about clinical assessments, goals of care, and the pathway to optimal outcomes are bound to occur with some regularity in the dynamic environment of labor and delivery. Every person has the responsibility to contribute to improving how we relate to and communicate with each other.

"Collectively we must create environments in which every team member (patient, physician, midwife, nurse, unit clerk, patient care assistant, scrub tech, etc.) is comfortable expressing and discussing their concerns about safety and performance, and is encouraged to do so, and has the support of the team to articulate their rationale for and urgency of their concern without fear of put-downs, retribution, or receiving poor quality care."
ACNM, ACOG, AWHONN and SMFM will continue to work together to create tools and training protocol to further collaboration and ensure communication and teamwork.

Go to to read the full article.

About the organizations:

The American College of Nurse-Midwives (ACNM) is the professional association that represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States. ACNM promotes excellence in midwifery education, clinical practice, and research. With roots dating to 1929, our members are primary care providers for women throughout the lifespan, with a special emphasis on pregnancy, childbirth, and gynecologic and reproductive health. ACNM provides research, administers and promotes continuing education programs, establishes clinical practice standards, and creates liaisons with state and federal agencies and members of Congress to increase the visibility and recognition of midwifery care.

The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation's leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 58,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women's health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization.

Since 1969, the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) has been the foremost authority promoting the health of women and newborns and strengthening the nursing profession through the delivery of superior advocacy, research, education and other professional and clinical resources. AWHONN represents the interests of 350,000 registered nurses working in women's health, obstetric, and neonatal nursing across the United States. Learn more about AWHONN at

The Society for Maternal-Fetal Medicine (est. 1977) is the premiere membership organization for obstetricians/gynecologists who have additional formal education and training in maternal-fetal medicine. The society is devoted to reducing high-risk pregnancy complications by sharing expertise through continuing education to its 2,000 members on the latest pregnancy assessment and treatment methods. It also serves as an advocate for improving public policy, and expanding research funding and opportunities for maternal-fetal medicine. The group hosts an annual meeting in which groundbreaking new ideas and research in the area of maternal-fetal medicine are shared and discussed. For more information visit


Clare Lynam

Kate Connors

Kelly Mack

Vicki Bendure, APR


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