A study from the University of Arkansas for Medical Sciences (UAMS) finds that while obstetric emergencies are common in Arkansas emergency departments (EDs), many hospitals lack key protocols, training, and capabilities needed to manage life-threatening maternal complications.
UAMS researchers surveyed managers from 51 EDs, representing 61% of all hospital-based EDs statewide, to evaluate their experiences, capabilities and training related to obstetric emergencies. In the previous year, 43% of EDs reported a birth, 71% managed urgent transports of pregnant or postpartum patients, and nearly half experienced an unanticipated adverse maternal outcome.
Despite the frequency of obstetric cases, the study found:
-Only 31% of EDs required documentation of pregnancy status in the electronic health record.
-46% had no field to record postpartum status — an important gap given that many maternal deaths occur after delivery.
-Fewer than half (46%) had provided any obstetric emergency training in the past two years.
Even hospitals without obstetrics units frequently care for high-risk patients, particularly in rural areas where more than 60% of Arkansas counties lack obstetric services. Differences in preparedness may contribute to maternal health inequities in Arkansas, a state with one of the highest maternal mortality rates in the nation.
Faculty at UAMS are already working to address the gaps identified in this study through the Arkansas Perinatal Quality Collaborative (ARPQC). Luann Racher, MD, associate professor of Obstetrics & Gynecology at UAMS, develops and leads trainings for ED staff and emergency medical services throughout the state with the ARPQC.
“We are preparing ED staff to manage complications like pregnancy-related hypertensive emergencies, precipitous birth and postpartum hemorrhage through skills-based simulation trainings and standardized clinical algorithms,” Racher said.