How Every Postpartum Hemorrhage Harms Every Other Birthing Person on the Unit

Abstract

Every birthing person on a unit is harmed when a postpartum hemorrhage (PPH) occurs because staff, blood, medication, supplies, and more are diverted to attend to the crisis. When caring for a woman with PPH, multiple nurses are pulled from their existing patients (often set up as 1:1 nurse:patient ratio) to assist, thus increasing the chances of another safety event. Instead, unit staff should minimize the risk for PPH with limited obstetric interventions, support physiological birth, prepare for PPH (i.e., through simulations, maintaining the hemorrhage cart, making medications easily available, having a blood replacement plan in place, closely assessing the postpartum patient). Plan to reduce elective inductions and multiple obstetric-unit closures that have created a bottleneck situation in care resources during a highly acute care situation. Information is provided on the obstetric-unit closures in Philadelphia during the last 20 years. Risk predictive models are limited in their utility, but known risks exist.