Making Childbirth Safer for Navy Moms and Babies

Childbirth can be risky for mothers and babies, and although modern obstetrical care yields good outcomes for most, some births may end in injury or death.

To track and further reduce such adverse outcomes, the U.S. Navy’s Bureau of Medicine and Surgery (BUMED) sought a reporting mechanism and data on obstetric care.

Altarum worked with Navy analysts to create an interactive monthly reporting program to guide data-driven decisions to improve the care provided to mothers and babies in the Military Health System. The new reports help BUMED identify and review nine adverse outcome indexes and three composite metrics within Navy treatment facilities and compare them with those from other military services and civilian hospitals. The indexes include a range of outcomes that vary in severity from perineal lacerations to fetal, newborn, or maternal death.

In addition, one team member developed a statistical model to determine whether less severe adverse events could be used to predict three catastrophic events: maternal death, neonatal death, or uterine rupture.

Another team member’s expertise on maternal and child health persuaded the Navy to consider additional measures in tracking outcomes. With her help, the team developed a Perinatal Report Card to track a range of obstetric-related metrics that affect maternal and child health, such as hepatitis B vaccine administration, smoking cessation, and adequacy of weight gain. The report adds other relevant indicators, such as immunization, cesarean, and episiotomy rates, to the adverse outcome metrics, creating a fuller picture of Navy practices.

With these insights, BUMED is poised to expand its understanding of its comprehensive obstetrics quality program and to help bring the attention of medical facility administrators to challenges and concerns.

Altarum-led innovations will affect the future of obstetrical care in Navy medicine and ensure that it continues its mission to provide world-class health care. Project Leader Christina Ciucci said, “This project allowed me to work with dedicated and passionate clients who put the health and safety of moms and babies first on their list. We had a chance to meet the needs of Navy Medicine and, even better, to exceed their expectations by advising them on how to continue to move forward in their mission.”