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Solutions in Sight

Safety Initiatives Have Dramatically Reduced Harms During Childbirth But Are Unevenly Implemented

A new Public Citizen report illustrates that certain health care organizations have made extraordinary progress in the past 15 years in reducing infant mortality, maternal deaths, birth trauma and other tragic outcomes relating to childbirth.

Many of these gains were achieved by implementing policies that ensured adherence to accepted practice protocols, as well as simple training to reduce communications errors.

The stakes are of the highest order. About 25,000 babies a year die in their first year of life in the United States, and the United States has one of the highest infant-mortality rates among developed countries. One of the providers cited in the report was able to cut its neonatal mortality rate nearly in half across all 43 of its hospitals in just two years.

Despite isolated examples of progress, experts agree that practice patterns within the obstetrics profession remain widely disparate and that adherence to best practices within the profession is not nearly comprehensive.

The remarkable success of safety initiatives at reducing untoward outcomes juxtaposed with the failure of many providers to institute similar reforms suggests that many otherwise avoidable tragedies are likely continuing to occur at non-adopting institutions.