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EP5- How The Healthcare System Is Failing Pregnant Women and What Can Be Done About It

February 14, 2018

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EP5- How The Healthcare System Is Failing Pregnant Women and What Can Be Done About It

February 14, 2018




There has been an increase in maternal death awareness in the last 60 days. Dr. Debra Bingham explains the main reasons behind this, including increase in caesarian births, induced labor and around public health policies and access. They also discuss the difference in access to healthcare in different communities and women reporting that they are not being heard in the doctors office and delivery room. In this podcast, we discuss how the healthcare system is failing pregnant women and what can be done about it.


Why are maternal deaths increasing in the US?

The reasons are multi-factorial, but there are 3 major reasons:


1. Women's health before, during and after pregnancy do affect outcome. But too often people focus on that reason.

2. Changes in healthcare or healthcare quality improvement and safety needs ways in which we need to improve healthcare.

3. Around public health policies.

There have changes in healthcare in the US. For example, there have been increases in cesarian births without any benefit being demonstrated in any of the public health statistics.

There have also been changes in regards to overuse of induction of labor which leads to higher rates of maternal hemorrhages.

There have been increases in obesity and diabetes, and that is not going in the right direction.

Access has been better, but there is always risk for people in different communities to not have access in some states. 



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Senator Karen Keiser


Debra Bingham, DrPH, RN, FAAN


Associate Professor, University of Maryland, School of Nursing and

Founder and Executive Director Institute for Perinatal Quality Improvement


Dr. Debra Bingham has over 30 years experience in Maternal Child Health Nursing, a master's degree in perinatal nursing from Columbia University, and a doctorate in Public Health from the University of North Carolina-Chapel Hill. Most of Debra's career has been spent working in hospital leadership positions at the front lines of healthcare. For example, she has held the positions of Director of Maternal Child Health Nursing for 2 union hospitals in New York City, Manager of a large referral Neonatal Intensive Care Unit in New York City, a stand-alone birthing center in a small community hospital, and a fetal evaluation unit.


Debra has expertise in Quality Improvement (QI), health care safety, and implementation science.  Her dissertation was on how to improve front-line clinician’s quality improvement implementation effectiveness.  In addition, she has led numerous QI inter-disciplinary initiatives designed to improve the safety of healthcare.  She is an author of numerous articles published in peer reviewed journals and of implementation toolkits. Dr. Bingham was the first Executive Director of the California Maternal Quality Care Collaborative where she helped form the collaborative and the California Pregnancy-Associated Mortality Review (CA-PAMR) committee, co-authored the Obstetric Hemorrhage Toolkit, and launched the first CA-Obstetric Hemorrhage Multi-Hospital Collaborative. Debra was the Vice President of Research, Education, and Practice for the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) where she led the development and launch of the Postpartum Hemorrhage Project, the Women’s Health and Perinatal Nursing Care Quality Measures, the Maternal Fetal Triage Index, and the #POSTBIRTH Warning Signs program.  Debra was the Chair of the Council in Patient Safety in Women’s Healthcare (a volunteer organization comprised of representatives from 17 professional organizations). Debra is a Lamaze Certified Childbirth Educator and former Chair of Lamaze International's Institute for Safe and Healthy Births. 


Currently Dr. Bingham is an Associate Professor of Healthcare Quality and Safety at the University of Maryland School of Nursing, a perinatal consultant and the founder and Executive Director of the Institute for Perinatal Quality Improvement ( 

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