Obstetric Readiness in Emergency Departments
About Louisiana’s Obstetric Readiness in Emergency Departments Initiative
The Obstetric Readiness in Emergency Departments Initiative was created to improve care for pregnant, postpartum, and lactating patients seeking care in emergency departments.
According to the March of Dimes,1 approximately one-fourth of parishes in Louisiana have no hospital or birthing center offering obstetric care and are without any obstetric clinician. Also, 12.1 percent of women have no birthing hospital within 30 minutes of where they live, increasing care in emergency departments.1 Based on the 2020 Louisiana Pregnancy-Associated Mortality Review,2 a majority of pregnancy-related deaths occurred after delivery, up to one year postpartum, with most occurring in the first 42 days.
Through the Obstetric Readiness in Emergency Departments Initiative, the Louisiana Perinatal Quality Collaborative provides tools, training, and quality improvement coaching to help emergency departments implement evidence-based, standardized protocols, processes, and structures. These offerings strengthen the ability of emergency departments to manage obstetric conditions, ultimately improving maternal, perinatal, and neonatal outcomes across Louisiana.
Areas of Work for the Initiative
Through collaborative learning and training, the Louisiana Perinatal Quality Collaborative helps teams participating in the Obstetric Readiness in Emergency Departments Initiative establish protocols and processes for:
- Conducting routine screening and assessment of pregnancy, postpartum, and lactation status in all applicable emergency department patients.
- Adopting best practices for screening, diagnosing, and treating severe hypertension in pregnancy and postpartum.
- Educating emergency medical providers on urgent maternal warning signs.
- Promoting effective, multidisciplinary debriefs following obstetric emergencies.
Key Resources
- Alliance for Innovation on Maternal Health – Obstetric Emergency Readiness Resource Kit: A collection of best practices to aid in readiness efforts to appropriately care for those experiencing obstetric emergencies in non-obstetric or lower-resourced settings.
- Alliance for Innovation on Maternal Health – Obstetric Simulation Scenarios: These scenarios are intended to be adapted for a variety of facility and resource levels and to meet the goals established by the teams participating in simulation. Each scenario may be used in any level of fidelity simulation, from tabletop or virtual drill use to high fidelity simulation in formal simulation centers or with standardized patients.
- Association of Women’s Health, Obstetric and Neonatal Nurses | Consensus Statement- Emergency Care for Patients During Pregnancy and the Postpartum Period: Details the consensus of the Emergency Nurses Association and the Association of Women’s Health, Obstetric, and Neonatal Nurses on the standards that should be achieved in emergency services.
- American College of Obstetricians and Gynecologists Identifying and Managing Obstetric Emergencies in Non-Obstetric Settings: Resources for emergency department, emergency medical services, and urgent care practitioners to enhance readiness to identify and respond to obstetric emergencies.
- American College of Obstetricians and Gynecologists Acute Hypertension in Pregnancy and Postpartum Algorithm: A step-by-step, structured process (flowchart) that guides healthcare providers in making clinical decisions related to acute hypertension in pregnant and postpartum patients.
References:
- March of Dimes. 2023. Where you live matters: Maternity care access in Louisiana. March of Dimes.
- Health, Louisiana Bureau of Family. 2025. “2020 Louisiana Pregnancy-Associated Mortality Review.”
Initiatives
The Gift
The primary home for neonatal and mother-baby care best practice implementation, including breastfeeding and parent-infant bonding.
Safe Births Initiative
The primary home for the Alliance for Innovation on Maternal Health bundle of implementation and perinatal outcomes work.
Obstetric Readiness in Emergency Departments
Supports emergency departments to improve readiness for obstetric emergencies.
Caregiver Perinatal Depression Screening
Supports pediatric practices in screening and establishing referral pathways for caregivers impacted by postpartum depression.
Community Birth Initiative
Supports freestanding birth centers and community birth providers with readiness and response to maternal and neonatal emergencies.