Development of a High-Risk Maternal–Newborn Transport Team

Abstract

To improve the process for safe transports of pregnant women and to develop a transport team for high-risk pregnant women and their neonates. It is the responsibility of a regional perinatal intensive care center to provide primary obstetric care to women with high-risk pregnancies and to their high-risk neonates. As the third largest birth system in the state, with more than 4,500 births last year, and the sole perinatal intensive care center in the region, the safety of pregnant women and their newborns is a priority. The health system and surrounding community needs are changing and now require a safe method to transport women with high-risk pregnancies who are in labor and women who are ready to give birth but are in a facility that does not offer inpatient labor and delivery services. The use of current resources within the established pediatric and neonatal transport team provided a solid foundation for developing the service line. A multidisciplinary group of stakeholders participated in the development, including transport team leadership, nurse and physician obstetric leadership, transfer center staff, as well as hospital administration. The addition of a perinatal nurse allows for the women in labor to receive proper care from the team as well as have the backup of a neonatal team in the event the mother gives birth. The new service also provides the ability to transport a woman who has given birth in an outlying emergency room in the same ambulance with her newborn safely. After 4 months of being in service, the team has safely transported 74 pregnant women and 7 mother–newborn pairs. Eleven of the women were from out of county, with a distance of 24 miles and greater to the regional care center. Sixty-two percent of the women were admitted for ongoing monitoring, birth, or emergent cesareans, and 36% of the women were triaged in the obstetric emergency department, monitored, and subsequently discharged. Currently, the transport team provides a high level of care for the surrounding five regional counties through a mobile intensive care unit. With the addition of a perinatal nurse, we are able to provide safe and critical services to pregnant women in our community.