Post Wendy
School of Nursing, George Washington University, Ashburn, Virginia, USA.
Health Equity. 2025 May 16;9(1):266-268. doi: 10.1089/heq.2024.0065. eCollection 2025.
Maternal mortality and morbidity are enduring public health crises disproportionately affecting Black, Indigenous, Hispanic, and other marginalized populations. This inequity highlights the necessity for a comprehensive, equity-driven framework to address systemic failures within maternal healthcare. Although the Maternal Mortality Review Information Application (MMRIA) provides valuable retrospective insights into maternal deaths, its capabilities must be expanded by integration with real-time interventions. Innovative approaches, including obstetric decompensation scoring tools like the Obstetric Early Warning Score and Maternal Early Warning Score (OEWS) and Maternal Early Warning Trigger systems, are strongly advocated. These predictive technologies, when integrated into electronic medical records, generate real-time alerts that enable clinicians to proactively mitigate complications before they escalate. Simulation-based training further complements these technologies, immersing healthcare teams in realistic, high-stress scenarios drawn directly from maternal mortality case studies. Such immersive programs effectively address implicit biases, enhance diagnostic accuracy, and foster cultural humility, particularly benefiting marginalized populations. Additionally, the establishment of Maternal Morbidity Review Committees (MMORCs) is proposed as a critical advancement, enabling multidisciplinary, immediate interventions during acute maternal events. Collectively, these innovations aim to transition maternal health care from a reactive to a proactive model, significantly improving maternal outcomes. Highlighted is the urgency for systemic reforms and data-driven interventions to eliminate inequities, prioritizing prevention, equity, and cultural humility to ensure maternal healthcare is equitable, accesible and inclusive.
孕产妇死亡率和发病率是长期存在的公共卫生危机，对黑人、原住民、西班牙裔和其他边缘化人群的影响尤为严重。这种不平等凸显了建立一个全面的、以公平为导向的框架的必要性，以解决孕产妇医疗保健中的系统性缺陷。尽管孕产妇死亡审查信息应用程序（MMRIA）为孕产妇死亡提供了有价值的回顾性见解，但其功能必须通过与实时干预措施相结合来加以扩展。强烈提倡采用创新方法，包括诸如产科早期预警评分（OEWS）和孕产妇早期预警评分等产科失代偿评分工具以及孕产妇早期预警触发系统。这些预测技术在集成到电子病历中后，会生成实时警报，使临床医生能够在并发症升级之前主动加以缓解。基于模拟的培训进一步补充了这些技术，让医疗团队沉浸在直接取材于孕产妇死亡案例研究的逼真、高压力场景中。此类沉浸式项目有效地解决了隐性偏见问题，提高了诊断准确性，并培养了文化谦逊态度，尤其使边缘化人群受益。此外，提议设立孕产妇发病审查委员会（MMORCs），作为一项关键进展，以便在孕产妇急性事件期间进行多学科的即时干预。总体而言，这些创新旨在将孕产妇医疗保健从被动模式转变为主动模式，显著改善孕产妇结局。强调了进行系统性改革和数据驱动干预以消除不平等现象的紧迫性，将预防、公平和文化谦逊作为优先事项，以确保孕产妇医疗保健公平、可及且具有包容性。
