Continuity, consistency, and care access: Reimagining what’s possible in perinatal care

In a perfect world, every birth would be a safe and joyful experience. But those of us who work in maternal care know that the reality can at times look very different. For too many families, childbirth comes with fear, complications, and in the worst cases, devastating loss. 

In the United States, where the maternal mortality rate is the highest¹ among all high-income nations, we’re facing a maternal health crisis. Nearly 700 women die each year² from pregnancy-related complications and for every life lost, another 70 women experience severe, often life-altering complications.³ Beneath these alarming figures is a tragic truth: an estimated 84% of these pregnancy-related deaths are preventable.⁴ 

As a nurse, I’ve seen firsthand how the right information at the right moment can make all the difference. Moving toward care models that emphasize early recognition and enable timely action—especially for conditions like hemorrhage and preeclampsia—can help prevent some avoidable outcomes. 

Perinatal standards reflect this urgency, but real progress depends on making it easier for care teams to deliver safe, connected care.⁵ By focusing on establishing continuity, consistency, and care access, we can help build a system where every mother receives the care she needs, every step of the way. 

Continuity: Giving care teams the full picture

In labor and delivery, things can change in an instant, which makes real-time, connected information essential. But when data is fragmented across systems, or passed along informally between shifts, those decisions can become harder to make, and important details may slip through the cracks. 

This kind of breakdown isn’t rare. In fact, a recent review of more than 23,000 malpractice claims found that over 30% were caused by communication failures. These lapses were associated with nearly 2,000 preventable deaths and over $1.7 billion in associated costs.⁶ The Joint Commission has echoed similar findings, reporting that miscommunication during handoffs is a factor in nearly one-third of malpractice claims.⁷ 

The challenge is especially pronounced in busy units, where patient handoffs typically occurs during shift changes four times per day.⁸ And, at one large teaching institution, knowledge transfers happen when giving report from nurse to physician and nurse to nurse, which accounted for at an estimated 4,000 knowledge transfers per day.⁹ When each transition depends on memory or scattered documentation, the clinical context that matters most can easily be lost. 

Technology can help play a critical role in improving continuity. Tools that provide real-time* access to cumulative patient data—like maternal vitals and fetal heart rate trends—can help clinicians recognize emerging risks quickly and intervene earlier. A multicenter study published in The New England Journal of Medicine found that using structured handoff protocols, supported by technology, reduced preventable adverse events by 30%.¹⁰ 

A renewed focus on continuity helps establish a shared, reliable source of truth, so that care teams can respond with confidence, precision, and speed. When everyone is working from the same information, it’s easier to recognize warning signs early, coordinate more smoothly, and make confident decisions under pressure. In those critical moments, that kind of shared understanding can make all the difference. 

Consistency: Supporting timely care in a high-pressure setting

In labor and delivery, everything can shift in the blink of an eye. In those moments, how we respond matters deeply. In unpredictable situations like these, variability in how we assess and act can increase risk for both patients and care teams.

Guidelines from the Joint Commission and AIM offer a critical foundation, but following protocols consistently can be challenging, especially in moments of high pressure. When nurses are supported with tools that help to simplify decision-making, it helps keep us ahead of the challenges, creating a safer and more personalized healthcare environment. 

Some of the methods we rely on most, like visual estimation of blood loss or manually tracking blood pressure, leave too much room for interpretation. When every second counts, that subjectivity can delay escalation or prompt interventions we may not need, eroding both patient safety and provider confidence. 

Automated supports offer the consistency we need, without replacing clinical judgement. Digital fetal heart rate (FHR) interpretation, quantifiable blood loss measurement, and real-time* decision support help us act earlier, with confidence and clarity, even when the unit is stretched thin. 

Care access: Bridging gaps to support every patient

As nurses, we want every person who walks through our doors to feel safe, seen, and cared for. But the truth is, access to quality maternal care is not readily available for all. In the U.S., Black women are three times more likely to die from pregnancy-related causes than white women.¹¹ Social and structural barriers of health, including where someone lives, how close they are to a hospital, and whether that hospital is properly staffed, shape those outcomes long before labor begins.¹² 

To deliver consistent access to high quality care across all birthing settings, we need technology that reflects the full spectrum of people we care for. That starts with collecting and validating data from a wide range of populations—across races, ethnicities, geographies, and levels of care. When our tools are built on truly representative data, they enable clinicians to make safer, more informed decisions for every patient in every location. 

Care access is also about whether care teams have the resources, people, and support they need to show up fully for their patients. Chronic understaffing, high patient loads, and administrative burdens place additional pressure on caregivers, making it harder to maintain high standards of care. 

Even before the pandemic, burnout was widespread with up to 45% of nurses reported feeling emotionally exhausted and overworked.¹³ With nurse turnover approaching nearly 26%, we’re feeling the strain more than ever.¹⁴ 

That’s why the tools we rely on need to support both the diverse array of patients we care for and the myriad of advanced use cases that alleviate manual tasks, help minimize unwanted variations in care, and augment clinical decision making. Technology that lightens our load instead of adding to it, like automated vitals monitoring or systems that give a clearer view of patient risk, can help us act faster and stay focused on what matters most—providing the best possible care for everyone who needs it. 

Technology: A foundation for the future of perinatal care

Every preventable loss is one too many. I’ve seen how quickly things can change in labor and delivery and how essential it is to have not only the right team, but the right technology in place to support it. When it matters most, we need systems that can help us act quickly toward the safest path forward. 

Continuity, consistency, and care access shape how care feels, how decisions are made, and ultimately, how outcomes unfold. Technology, when thoughtfully designed and grounded in real clinical needs, can strengthen each of these pillars. It helps us spot risks sooner, respond with greater clarity, and stay grounded in evidence, even at a million miles per hour. 

Even outside of rich insights and intelligent alerts, it’s also about creating the kind of environment where all patients feel seen and supported, and where care teams feel equipped and confident. Technology can help turn this vision into standard practice, so we can build a future where maternal and infant safety is the rule, not the exception. 

* Requires real-time HL7 data feed from devices.

References

1. Commonwealth Fund. (2024, June 4). Insights into the U.S. maternal mortality crisis: An international comparison. https://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison
2. Petersen EE, Davis NL, Goodman D, et al. Vital Signs: Pregnancy-Related Deaths, United States, 2011–2015, and Strategies for Prevention, 13 States, 2013–2017. MMWR Morb Mortal Wkly Rep. 2019; 68(18):423–429. https://doi.org/10.15585/mmwr.mm6818e1
3. American College of Obstetricians and Gynecologists. (n.d.). Policy priorities: Maternal mortality prevention. https://www.acog.org/advocacy/policy-priorities/maternal-mortality-prevention
4. Centers for Disease Control and Prevention. (2024, May 28). Pregnancy-related deaths: Data from maternal mortality review committees in 36 U.S. states, 2017–2019. https://www.cdc.gov/maternal-mortality/php/data-research/mmrc-2017-2019.html
5. The Joint Commission. (2020, July 1). PC standards for maternal safety. https://www.jointcommission.org/standards/r3-report/r3-report-issue-24-pc-standards-for-maternal-safety/#.ZFlMmXbMKUk
6. The HIPAA Journal. (2025, April 2). Effects of poor communication in healthcare. https://www.hipaajournal.com/effects-of-poor-communication-in-healthcare/
7. The Joint Commission. (2017, September 12). Sentinel event alert: Inadequate hand-off communication. https://www.jointcommission.org/-/media/tjc/newsletters/sea-58-hand-off-comm-9-6-17-final2.pdf
8. Birmingham, P., Buffum, M. D., Blegen, M. A., & Lyndon, A. (2015). Handoffs and patient safety: Grasping the story and painting a full picture. Western Journal of Nursing Research, 37(11), 1478–1493. https://pmc.ncbi.nlm.nih.gov/articles/PMC4272331/
9. Association of American Medical Colleges. (2019, June 6). 20 years of patient safety. https://www.aamc.org/news/20-years-patient-safety
10. Starmer, A. J., et al. (2014, November 6). Changes in medical errors after implementation of a handoff program. New England Journal of Medicine, 371(19), 1803–1812. https://doi.org/10.1056/NEJMsa1405556
11. Centers for Disease Control and Prevention. (2024, April 8). Working together to reduce Black maternal mortality. https://www.cdc.gov/womens-health/features/maternal-mortality.html
12. Wang, E., Glazer, K. B., Howell, E. A., & Janevic, T. M. (2021, April 1). Social determinants of pregnancy-related mortality and morbidity in the United States: A systematic review. Obstetrics & Gynecology, 135(4), 896-915. https://pmc.ncbi.nlm.nih.gov/articles/PMC7104722/
13. Department of Health and Human Services. (2022). Addressing health worker burnout. https://www.hhs.gov/sites/default/files/health-worker-wellbeing-advisory.pdf
14. NSI Nursing Solutions, Inc. (2025, March). 2025 NSI national health care retention & RN staffing report. https://www.nsinursingsolutions.com/documents/library/nsi_national_health_care_retention_report.pdf

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