Skip to main content

National Initiatives to Improve Systems for Postpartum Care


Purpose To showcase several current national initiatives that focus on reducing maternal mortality and severe maternal morbidity and promote postpartum health and wellness for all women. Description Maternal injuries and deaths are a serious public health concern with tremendous impact on families, communities, and healthcare providers. Over the past two decades, it has become apparent that the timing of serious maternal complications has shifted, with more than half of deaths occurring in the immediate postpartum period up to 1 year following birth. Many of these reported deaths could have been prevented, and the number of “near misses” of maternal morbidity cases continues to grow exponentially. In addition, postpartum women experience substantial unmet health needs, compromising their wellbeing. Assessment The American College of Obstetricians and Gynecologists and the Association of Women’s Health, Obstetric, and Neonatal Nurses have thoroughly assessed the significance of the rising trends in maternal morbidity/mortality and are leading efforts to reduce these rates and improve overall health and wellbeing for all women during the postpartum period. Conclusion Developing national initiatives to improve postpartum health are vital to increasing the effectiveness of postpartum discharge education, and improving the participation in and the quality of postpartum care. Hopefully, evidence-based practice and widespread dissemination of these efforts will lead to a reduction in preventable post-birth maternal morbidity and mortality.

This is a preview of subscription content, access via your institution.


  • American College of Obstetricians and Gynecologists. (2016). Committee opinion no. 666: Optimizing postpartum care. Obstetrics and Gynecology, 127(6), e187–e192.

    Article  Google Scholar 

  • Bacak, S. J., Berg, C. J., Desmarais, J., Hutchins, E., & Locke, E. (2006). State maternal mortality review: Accomplishments of nine states. Atlanta: Centers for Disease Control and Prevention.

    Google Scholar 

  • Berg, C. (2011). From identification and review to action—Maternal mortality review in the United States. Seminars in Perinatology, 36, 7–13.

    Article  Google Scholar 

  • Berg, C. J., Harper, M. A., Atkinson, S. M., Bell, E. A., Brown, H. L., Hage, M. L., … Callaghan, W. M. (2005). Preventability of pregnancy-related deaths: Results of a state-wide review. Obstetrics and Gynecology, 106(6), 1228–1234.

    Article  PubMed  Google Scholar 

  • Bingham, D. (2012). Eliminating preventable hemorrhage-related maternal mortality and morbidity. JOGNN: Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41(4), 529–530.

    Article  Google Scholar 

  • Callaghan, W. M., Creanga, A. A., & Kuklina, E. V. (2012). Severe maternal morbidity among delivery and postpartum hospitalizations in the United States. Obstetrics and Gynecology, 120(5), 1029–1036.

    PubMed  Google Scholar 

  • Center for Disease Control (CDC). (2016). Pregnancy mortality surveillance system. Retrieved from and

  • Coeytaux, F., Bingham, D., & Strauss, N. (2011). Maternal mortality in the United States: A human rights failure. Contraception, 83(3), 189–193. doi:10.1016/j.contraception.2010.11.013.

    Article  PubMed  Google Scholar 

  • Creanga, A. A., Berg, C. J., Syverson, C., Seed, K., Bruce, C., & Callaghan, W. M. (2012). Race, ethnicity and nativity differentials in pregnancy-related mortality in the United States: 1993–2006. Obstetrics and Gynecology, 120, 261–268.

    Article  PubMed  Google Scholar 

  • Creanga, A. A., Berg, C. J., Syverson, C., Seed, K., Bruce, F. C., & Callaghan, W. M. (2015). Pregnancy-related mortality in the United States, 2006–2010. Obstetrics and Gynecology, 125, 5–12.

    Article  PubMed  Google Scholar 

  • Declercq, E. R., Sakala, C., Corry, M. P., Applebaum, S., & Herrlich, A. (2013). Listening to mothers III: New mothers speak out. New York: Childbirth Connection.

    Google Scholar 

  • Guendelman, S., Thornton, D., Gould, J., & Hosang, N. (2005). Social disparities in maternal morbidity during labor and delivery between Mexican-born and US-born White Californians, 1996–1998. American Journal of Public Health, 95, 2218–2224.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kassebaum, N. J., Bertozzi-Villa, A., Coggeshall, M. S., Shackelford, K. A., Steiner, C., Heuton, K. R., & Lozano, R. (2014). Global, regional, and national levels and causes of maternal mortality during 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet, 384(9947), 980–1004.

    Article  PubMed  PubMed Central  Google Scholar 

  • Suplee, P., Bloch, J., McKeever, A., Borucki, L., Dawley, K., & Kaufman, M. (2014). Focusing on maternal health beyond breastfeeding and depression during the first year postpartum. JOGNN: Journal of Obstetric, Gynecologic & Neonatal Nursing, 43(6), 782–791. doi:10.1111/1552-6909.12513.

    Article  Google Scholar 

  • The California Pregnancy-Associated Mortality Review. (2011). Report from 2002 and 2003 maternal death reviews. Sacramento: California Department of Public Health, Maternal Child and Adolescent Health Division.

    Google Scholar 

Download references


AWHONN’s postpartum discharge education program described in this paper was supported by funding from Merck, through its Merck for Mothers program. Funding was used for general financial support, including staff salaries, travel, and overhead. Merck had no role in the design, collection, analysis and interpretation of data, in writing of the manuscript, or in the decision to submit the manuscript for publication. The content of this publication is solely the responsibility of the authors and does not represent the official views of Merck.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Lisa Kleppel.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kleppel, L., Suplee, P.D., Stuebe, A.M. et al. National Initiatives to Improve Systems for Postpartum Care. Matern Child Health J 20 (Suppl 1), 66–70 (2016).

Download citation

  • Published:

  • Issue Date:

  • DOI: