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New hospital reporting driving targeting improvement for Victorian women and families

Published 05/04/2022

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Leading the way nationally, Victoria started mandatory collection of data on severe harm to mothers in 2017. Backed by the evidence, maternity expert Adj Prof Tanya Farrell says we’re now best placed to target our biggest area of concern – postpartum haemorrhage.

Tanya Farrell

For almost five years now, Victorian health services have been reporting severe acute maternal morbidity (SAMM) for independent review.

This has allowed us to better understand the outcomes for women through their pregnancy and in the six weeks following childbirth – specifically related to admissions to an intensive care unit.

Consistent since reporting began, the biggest cause of admissions to an intensive care unit is postpartum haemorrhage (PPH), that is severe bleeding after childbirth.

In 2020 it was the cause of 36.9 per cent of all SAMM. That’s 72 women who were separated from their newborn and support networks during what is a critical time in any family.

  % of all SAMM Number of women
2017*   48% 40
2018 38% 91
2019 37% 97
2020    36.9% 72

* Mandatory reporting of SAMM started 1 July 2017.

While PPH is a leading cause of maternal mortality worldwide, we know there are some simple steps to take to minimise patient risk. 

There are well-documented policies available to manage PPH, including the Safer Care Victoria clinical guidance.

For the past three years, the independent Consultative Council on Obstetric and Paediatric Mortality and Morbidity has been reviewing these cases and extracting key lessons in PPH recognition, specific risk factors and the importance of rapid escalation to senior clinicians, midwives and obstetricians. 

We have recommended targeted improvement to help maternity services implement best practice, audit their performance and undertake staff training and education to improve recognition and management of PPH.

So I am pleased to see that as part of 100,000 Lives, we are partnering with health services on our Postpartum Haemorrhage Collaborative to reduce PPH.

From a health service perspective, this initiative will help improve outcomes and experiences for women, babies, and families.  

Some research suggests women can experience an ongoing fear of dying, relationship problems, and anxiety and depression for those who fall pregnant again. So while we don’t fully understand the patient experience of PPH, we can reasonably assume that this work will prevent some women from experiencing long-term psychological and societal impacts.

I look forward to being part of this initiative, and making a measurable difference for Victorian women and families.

Adj Prof Tanya Farrell is Chair of the independent Consultative Council on Obstetric and Paediatric Mortality and Morbidity.

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