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From 2006 to 2015

2006 to 2015 Saw Increase in Severe Maternal Morbidity

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Forty-five percent increase in rate of severe maternal morbidity at delivery; higher rate for black women
Infant mortality rates in the United States vary substantially by state

CDC: Infant Mortality Rate Varies Greatly Among States

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Low of 3.47 in Vermont to a high of 9.03 in Alabama in infant deaths per 1,000 live births
After cesarean delivery

Skin Microbiota Differ for Obese, Non-Obese Undergoing C-Section

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Obese women have significantly higher bacterial biomass of lower diversity at the incision site
Finding a practice that provides opportunities to do deliveries is a considerable barrier to performing obstetric deliveries

Doctors Have Difficulty Finding Practices Offering Deliveries

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Many family practitioners report that opportunity to do deliveries not available in practice they joined
Prophylactic administration of tranexamic acid does not reduce postpartum hemorrhage among women with vaginal delivery receiving prophylactic oxytocin

Prophylactic Tranexamic Acid Doesn’t Cut Postpartum Bleeding

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No significant drop in postpartum hemorrhage of 500 ml or more for women receiving oxytocin
A liposomal bupivacaine incisional block at the time of cesarean delivery does not improve pain scores in the first 48 hours postoperatively

Liposomal Bupivacaine Block No Aid for Cesarean Pain

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Pain scores, opioid use in the first 48 hours post-surgery were similar compared to placebo
Opioid use disorder rates at delivery more than quadrupled nationally from 1999 to 2014

CDC: Rates of Opioid Use Disorder Seen at Time of Delivery Up

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Rate of opioid use disorder at time of delivery quadrupled from 1999 to 2014
Inducing labor at 39 weeks may decrease the risk of cesarean section

Inducing Labor at Term Appears to Reduce Cesarean Risk

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Elective induction at 39 weeks also linked to lower risk of maternal high blood pressure disorders
For women after vaginal birth

For Postpartum Hemorrhage, Carbetocin Similar to Oxytocin

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Heat-stable carbetocin non-inferior for preventing blood loss of ≥500 ml, use of other uterotonic agents
Women in New Zealand who experienced severe maternal morbidity often do not receive information

Follow-up Lacking for Women With Severe Maternal Morbidity

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In New Zealand, large proportion did not receive event debrief, referral to social support or specialist