Back to Top Skip to main content Skip to sub-navigation

How Health Care for New Mothers is Improving Across the MHS

Photo of a medical provider checking out a pregnant woman Following a 2021 DHA procedural instruction to standardize clinical care processes and resources to prevent and treat post-partum hemorrhage incidents across the Military Health System, the Women’s Health Clinical Management Team drove a campaign to educate and train care staff and implement a post-partum hemorrhage bundle at 12 military hospitals in two initial waves. (Photo: Jacob Sippel, Naval Hospital Jacksonville/Released)

Recommended Content:

Women's Health | Postpartum Hemorrhage

For years the Military Health System has provided new mothers with high-quality care that consistently tops the civilian health care sector.

Now, the MHS is working to further improve that safety record by standardizing prevention and treatment for one of the biggest health risks for new mothers: post-partum hemorrhaging.

A rare, but serious condition that women can experience up to 12 weeks after childbirth, post-partum hemorrhaging, known as PPH, is the leading cause of preventable maternal deaths worldwide, said Air Force Col. Sheelah Walker, interim lead of the Defense Health Agency's Women's Health Clinical Management Team (WHCMT).

"While prevention of PPH is not always possible, prompt assessment, recognition, and communication of maternal hemorrhage risk, as well as timely interventions according to risk level, can reduce maternal morbidity and mortality and improve outcomes," she said.

The ongoing focus on maternal health care in the MHS has already pushed the rates of maternal and infant mortality down much lower than the United States overall, according to a 2019 report from the Office of the Secretary of Defense. The MHS rates in recent years were at 7.4 deaths per 100,000 live births, significantly lower than the 11.3 reported at non-MHS facilities nationally.

To build on that performance, the MHS has put in place new treatment protocols following national guidelines for staff to provide standardized care.

In January 2021, the DHA issued a procedural instruction (PI), establishing a set of standardized components to assist with postpartum hemorrhage clinical processes and resources that are aimed at improving maternal care.

Since then, the WHCMT has led a campaign to improve the implementation of risk assessment and access to resources to speed up the treatment and prevention of maternal complications during a mother's entire journey of obstetrical care – meaning before, during, and after the birth of her baby.

The campaign sought to implement the new guidelines and encourage staff compliance at 12 military hospitals in two initial waves. The process to decrease complications from postpartum hemorrhage is a world-wide initiative. MHS has been introducing the concepts and standards for the past two years.

The teams used adopted measures to track the changes in clinical practice and established a baseline for outcome metrics – such as incidence of PPH, blood transfusions, intensive care unit admission, and hysterectomy associated with PPH. The goal is to track improvements on the short and long-term impact on maternal outcomes, Walker said.

The effort has been a success. "As of September 2021, the post-partum hemorrhaging bundle campaign achieved 97% compliance," said Walker. This means they achieved their goal in less than a year since the PI was issued.

"Military hospitals overcame both local and MHS-wide challenges such as funding and procuring supplies, gaining staff buy-in, and aligning with electronic health record platform updates to be in compliance with PPH documentation requirements," she said.

The teams at the military hospitals now have access to a robust library of resources, support, and training materials as well as an established community of peers to engage and share leading practices, said Walker.

"The dedication and tireless work of the PPH champions at each military hospital enabled the establishment of PPH guidelines, hospital-specific policies and procedures, and staff training," said Walker. "Establishing the instruction and implementing the post-partum hemorrhaging bundle campaign sets the standard for providing standard, best-care practices for mothers."

The effort also aligns with guidance from the Alliance for Innovation on Maternal Health for requiring system-level readiness, recognition, response, and reporting, which is expected to support the reduction of maternal morbidity and mortality and improve patient outcomes.

"As all military hospitals adopt, adapt, and fully implement the DHA-PI, patients and staff will experience improvements in readiness to identify and treat hemorrhage; standardize supplies, equipment, and processes; decrease variation when staff transfer between military hospitals; automate outcome metrics for military hospitals to evaluate their care, and enhance the quality of care for all patients and their families," Walker said.

The campaign's work directly supports the local military hospitals by giving them the resources and tools they need to provide patients and staff with information and training about how to respond to PPH.

"Beginning in January 2022, all military hospitals that provide inpatient obstetric care are required to report compliance in accordance with PI guidelines on a quarterly basis, via an online data collection tool," said Walker.

You also may be interested in...

Historic observance celebrates the achievements of women

Article
3/25/2021
A flyer of three women in three separate pictures smiling

The DHA held a virtual observance—featuring a panel discussion on women’s history— in honor of Women’s History Month.

Recommended Content:

Brain Injury Awareness Toolkit | Brain Injury Awareness Toolkit | Women's Health

DHA implements standard practices to improve maternal outcomes

Article
3/24/2021
Military health personnel wearing face mask during medical training

DHA-PI 6025.35 provides guidance for implementation of a postpartum hemorrhage bundle at all MTFs providing obstetrical care.

Recommended Content:

Women's Health | Clinical Improvement Priorities for MTF Providers | Postpartum Hemorrhage

Decide + Be Ready: supporting today’s modern service woman

Article
3/23/2021
Picture of three different women with the words "decide and be ready mobile app"

New women’s app ‘Decide + Be Ready’, helps today’s service woman make proactive decisions regarding their contraceptive decisions.

Recommended Content:

Women's Health | Medical and Dental Preventive Care Fitness | Health Innovation Month

Women’s health emerging priorities series highlights mental health

Article
3/4/2021
A woman holding her hands near her face

Women’s mental health can be more affected by transitioning than men’s, speakers’ series attendees hear.

Recommended Content:

Women's Health | Total Force Fitness | Depression | Psychological Fitness

DOD initiatives address the sexual health of our military

Article
2/17/2021
Image of a bacterium

STIs are important to identify and treat because they can impact service members’ health and readiness, as well as their ability to perform their duties.

Recommended Content:

Armed Forces Health Surveillance Division | Health Readiness | Medical and Dental Preventive Care Fitness | Men's Health | Women's Health

COVID-19 vaccine does not affect fertility, immunization experts say

Article
2/16/2021
Black and white photo of a couple holding hands

COVID-19 vaccination when pregnant or breastfeeding shows no harm, immunologists weigh in.

Recommended Content:

Women's Health | Coronavirus | COVID-19 Vaccine Efforts | COVID-19 Vaccine Toolkit

DHA-PI: 6025.35: Guidance for Implementation of the Postpartum Hemorrhage Bundle

Policy

This Defense Health Agency-Procedural Instruction (DHA-PI), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (n), establishes the Defense Health Agency’s (DHA) procedures for military medical treatment facilities (MTFs) providing obstetrical (OB) care to implement standardized PPHB practices. Note, the use of the name or mark of any specific manufacturer, commercial product, commodity, or service in this publication does not imply endorsement by the Department of Defense (DoD).

Decreasing cervical cancer – one HPV vaccine at a time

Article
1/7/2021
Image of medical personnel showing report to soldier. Click to open a larger version of the image.

Early detection and prevention methods are key to help women fight and prevent this form of cancer.

Recommended Content:

Total Force Fitness Toolkit | Women's Health | Total Force Fitness | Total Force Fitness Toolkit

Transition support for servicewomen planning to leave the military

Article
11/10/2020
Three women in military uniforms standing together

As of today, the WHTT has supported more than 1,300 servicewomen to date.

Recommended Content:

Women's Health | DoD/VA Sharing Initiatives

Weed ACH hosted breast cancer awareness event

Article
10/28/2020
Woman in pink hat and shirt, wearing a racing number, speaking to an audience

National Breast Cancer Awareness Month is a chance to raise awareness about the importance of early detection of breast cancer.

Recommended Content:

Health Readiness | Combat Support | Women's Health

Special care given to families experiencing stillbirth or infant loss

Article
10/23/2020
A couple standing in front of a wall covered in notes

The cot is specially designed to give parents extra time with their baby.

Recommended Content:

Women's Health | Children's Health | Men's Health

Proactive screening and detection help to battle breast cancer

Article
10/22/2020
Soldier standing in front of a colorful display with pink ribbon

October is Breast Cancer Awareness Month.

Recommended Content:

Women's Health

Weed ACH holds Pregnancy & Infant Loss Awareness month event

Article
10/22/2020
Group of people standing outside hospital

[I]t's important to acknowledge pregnancy and infant loss awareness events because it isn’t healthy for families to suffer in silence.

Recommended Content:

Children's Health | Women's Health

NH Bremerton relies on experienced nurse to help new moms

Article
10/16/2020
Military personnel gives nurse an award

"Navy Medicine has taken me from novice to expert over a 20 year career..."

Recommended Content:

Combat Support | Women's Health | Patient Safety | Nursing in the Military Health System

Women’s mental health mini residency engages with DHA/VA providers

Article
9/28/2020
Female soldier, leaning against a military vehicle, at sunset

Annual training offers another perspective on women’s mental health.

Recommended Content:

Women's Health
<< < 1 2 3 4 > >> 
Showing results 16 - 30 Page 2 of 4

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.