Opinion: Obstetric hemorrhage continues to have our attention and dedication

This is written in response to the recent article published in the Anchorage Daily News regarding obstetric hemorrhage (”Alaska wants to tackle an increasing rate of obstetric hemorrhage among new mothers,” Dec. 22). We are obstetricians dedicated to safe delivery of obstetric care in the Alaska Tribal Health System and would like address some of the statements made in the article. Although the statistics presented may be correct, they lack context. We would like to give you a more in-depth perspective on this topic.

Obstetricians in Alaska have been aware of the risk of obstetric hemorrhage for decades. Like obstetricians across Alaska, the obstetricians in the Alaska Native Tribal Health System have been developing and refining evidence-based approaches to clinical care which ensure the safest birth for everyone at the hospital.

During prenatal care, pregnant women are screened for anemia twice and are treated to optimize their health before giving birth. There is ongoing review and updating of clinical guidelines as new technologies are developed to manage hemorrhage. During the birth hospitalization, women are stratified by risk so the team can facilitate situational awareness and preparedness. Recognition of obstetric hemorrhage is prompt with quantified blood loss and active treatment, including, when indicated, prompt surgical management. This is facilitated by obstetrician and anesthesiology teams available whenever a woman might need them. In addition to the robust processes in place, we engage in regular care team simulation training as well as quality assurance through a review of actual clinical care provided to women who experienced obstetric hemorrhage. We have dedicated September as Obstetric Hemorrhage Awareness Month. During this time, even more attention is paid to review knowledge, treatment and facts around obstetric hemorrhage with our labor and delivery teams and all other specialists who may care for pregnant women throughout the hospital.

The Alaska Department of Health initiative to increase awareness about obstetric hemorrhage is an important step toward ensuring all hospitals in Alaska have the tools needed to deliver safe care to women affected by obstetric hemorrhage. Physicians and nurses across tribal health are involved as faculty members collaborating with birthing centers and hospitals around the state sharing our experiences and ensuring best practices for anyone experiencing obstetric hemorrhage. Our obstetric hemorrhage efforts go beyond the best clinical care, as we have teams actively conducting research projects to work toward the prevention of obstetric hemorrhage. Simply measuring the frequency of obstetric hemorrhage by race, ethnicity, or location of birth does not tell the whole story about what could be causing obstetric hemorrhage in pregnant women, as each has a different risk profile. We partner with every birthing woman and their families to attain the safest outcome for her and her family.

For all those who are pregnant or have a pregnant family member reading this article, rest assured that obstetric care across Alaska is collaborative, high quality, and caring, and the health care workers providing this care are continuously improving the health and safety for women who are pregnant. We encourage you to be an active partner with your health care team by attending regular prenatal care and discussing how to minimize your risks and improve the health of your pregnancy. Lastly, feel free to ask your team what they have in place for obstetric hemorrhage. All of us who provide obstetric care in Alaska are here for you.

Reinou S. Groen MD, OB-GYN, Southcentral Foundation

Christina Rodriguez MD, OB-GYN, maternal fetal medicine, Southcentral Foundation

Melissa Tondre MD, OB-GYN, clinical department director, Southcentral Foundation

Leanne Komorowski MD, OB-GYN, hospital department director, Southcentral Foundation

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