Maternal Mortality Program Success Stories

Developed a “Train-the Trainer” model for implicit biases within obstetrical care. Facilitation teams identified six hospitals to implement this model across the state. These hospitals included: VUMC, Maury Regional, VUMC Wilson County, VUMC Northcrest, East Tennessee State University Johnson City, University of Tennessee Memphis, and Meharry Medical College.

Proposed to develop and distribute toolkits of information and resources, a novel workbook for mothers, and an educational series for providers aimed at preventing maternal mortality and morbidity. The target population was women receiving services through the ETSU Health Obstetrics and Gynecology, Family Medicine, and Pediatric Clinics, particularly those in the Baby Steps Antenatal Drug Use/Exposure program. The target population also included health and service providers in the region of Northeast Tennessee. ETSU also created the novel Caring for Motherhood Journal using evidence-based information on best practices from the Centers for Disease Control (CDC), American College of Obstetrics and Gynecology (ACOG), American Academy Family Practitioners (AAFP), and others.

Implemented the Mitigation Action for Maternal Mortality (MAMM) to mitigate the number of deaths caused by cardiovascular disease that occur during or after pregnancy. The MAMM team developed a Heart Awareness and Cardiovascular Disease flyer for distribution at focus groups, in physician offices, and for multiple audiences at other venues. The Heart Awareness and Cardiovascular Disease flyer, and a flyer about Preeclampsia were both distributed to OB providers and internists to inform and educate about risk factors and prevention strategies.

Proposed to decrease maternal mortality in Hamilton and surrounding counties in Tennessee by reducing existing disparities and ensuring that all staff and patients have access to the information they need to reduce risk factors and improve outcomes. To achieve this, Chattanooga Hamilton trained all of their maternal care staff which included 250 physicians, certified nurse midwives, advanced practice nurse practitioners and registered nurses in the following topics: recognizing and overcoming their own implicit bias, recognizing and addressing signs of pre-eclampsia, recognizing and addressing substance use disorders, and recognizing and addressing mental health disorders.

On July 9, 2020, the TN department of health received notification of the first pregnancy-associated COVID-19 death. In partnership with the Chief Medical Examiner’s Office, TN Department of Health’s Emergency Preparedness Program, and the Viral Hepatitis Program a collaborative effort with the Maternal Mortality Review (MMR) program was put into place to rapidly identify pregnancy-associated COVID-19 deaths. Every COVID-19 death reported to the Chief Medical Examiner’s Office where the pregnancy check box was checked the death was immediately reported to the MMR team. Additionally, if the Chief Medical Examiner’s office found a pregnancy reported in absence of the check box these deaths were also reported to the MMR team.

In September 2021, TDH was awarded $300,000 to strengthen TN’s review and prevention of homicide and suicide deaths that occur during pregnancy or within one year of pregnancy. The funding created the Prevention of Maternal Violent Deaths program and allowed TN to work towards reducing these deaths with community partners across the state. The Maternal Violent Deaths program increased surveillance of violent maternal deaths by utilizing ESSENCE to identify areas of high risk. The Maternal Violent Deaths program organized educational sessions for Evidenced-Based Home Visiting (EBHV) and CHANT staff on how to identify and address domestic violence in the home. The program also provided training opportunities for EBHV and CHANT on perinatal mood disorders. Training was conducted for healthcare providers on utilizing the lethality assessment.

Cherished Mom, a non-profit organization in East Tennessee, is committed to increasing the number of perinatal mental health providers in the state. TDH provided funding to Cherished Mom, through the CDC Preventing maternal Deaths: Supporting Maternal Mortality Review Committee’s grant, to facilitate PSI’s 2-day Perinatal Mental Health training free of cost to therapists, hospitalists, nurses, midwives and other interested providers who care for the perinatal population. A 3rd day of training was offered in advanced perinatal psychotherapy which enhanced providers’ ability to screen, counsel and prescribe appropriate medications for perinatal mood disorders.