Introduction

According to the Centers for Disease Control, “Perinatal quality collaboratives (PQCs) are state or multi-state networks of teams working to improve the quality of care for mothers and babies. PQC members identify health care processes that need to be improved and use the best available methods to make changes as quickly as possible.

PQCs have contributed to important improvements in health care and outcomes for mothers and babies, including:

• Reductions in deliveries before 39 weeks of pregnancy without a medical reason.

• Reductions in health care-associated bloodstream infections in newborns.

• Reductions in severe pregnancy complications.”

Many states in the USA, including my home state of Illinois, have their own CDC supported PQCs with the goal of:

• Reducing preterm births.

• Reducing severe pregnancy complications associated with high blood pressure and hemorrhage.

• Improving identification of and care for infants with neonatal abstinence syndrome.

• Reducing racial/ethnic and geographic disparities.

• Reducing cesarean births among low-risk pregnant women.

I am ready to participate

After reaching out to share my interest in serving on the Illinois PQC, I was invited to attend an upcoming meeting. The evening before I was scheduled to attend, I was nervous and frankly feeling a bit out of my league. I’d never even heard of a Perinatal Quality Collaborative before joining Lamaze International's Advocacy & Collaboration Committee this year, and I certainly would never have imagined it would be appropriate for me to participate in a statewide initiative that is headed up by prominent obstetricians.  Lamaze International Advocacy & Collaboration Committee Chair Jill Gerken Wodnick gracefully doula-ed me through, explaining that the people at the meeting would love my participation. Also, she gave me simple directions that helped — that my mission was to go, to meet people, and to learn. This I could do.

The meeting

On the agenda for the ILPQC OB Teams Face-to-Face Meeting were two main areas of focus: Improving Care for Mothers and Newborns Affected by Opioids (MNO) and continuing implementation of Immediate Postpartum Long-Acting Reversible Contraceptive Implementation (IPLARC).  [Note: An upcoming initiative is working to lower the rate of primary C-section births and I know Lamaze will be very helpful with ideas for that.]

The ILPQC is very focused on its mission, buttoned-up and efficient, working hard to institute widespread institutional change (learned skills that can serve all of us). They do this by using the following tactics:

• Keeping a sharp focus on planning and results — for example, using 30/60/90 day plans and establishing very specific and measurable goals such as >80% compliance.
• Providing lots of clear instructions about how meeting attendees should use their time there. “Take notes, take pictures,” go back to their teams with a clear plan. Make the hospital team they are representing feel like they were in attendance too.
• Working hard and smart so people don’t duplicate efforts with creating systems and avoiding common roadblocks. For example, participants shared storyboards at the meeting with specifics about what worked at their own health system. (I took pictures of the boards from hospitals nearest to me to make a note of who was on their team making change. I figure those are the people I might want to know as a childbirth educator and activist locally.)
• Being ready to acknowledge mistakes and eager to rectify them. For example, repeatedly it was mentioned that in the recent past, all the medical attention was paid to the newborn or fetus while often ignoring the opioid-addicted parent and their healthcare needs. At the meeting, many speakers reiterated that the “mother sitting in front of you” is the patient with the life-threatening condition, that they have a chronic and difficult illness that requires treatment.
• Acknowledging that provider attitudes can be a major roadblock when instituting change. They take it as a given and work with it.
• Distributing name tags that only listed first and last name and the company where they work. No initials, no titles. At a conference that welcomed a variety of professionals including physicians, nurses, hospital administrators, and social service workers, this really helped to put everyone on an equal footing.

Was attending this meeting worth my time?

I say 100% yes!

I know without a doubt that the Lamaze expertise in physiologic birth can play an essential role in state and regional initiatives to improve the lives of parents and babies. I suspect that this is an excellent time for Lamaze members to learn more about their own state’s perinatal quality collective since maternal health is (finally) the big news of the day. And, I’d tell any childbirth educator who suffers from imposter syndrome and fears that they are “less than” anyone else who might be in attendance to banish that thought! Childbirth educators know better than many care providers involved in pregnancy and birth just what parents are asking about and fearing the most. I believe that having that insight is vital when it comes to making big decisions about healthcare.

I’m so glad I took the time to attend the PQC. The experience demonstrated to me that the principles that Lamaze International is based on can be essential components for improving maternal and infant mortality and morbidity which will impact all families, particularly families of color who are most severely impacted.  The resources Lamaze has already developed and provide on their websites, such as infographics, Six Healthy Birth Practices, videos, and other materials, are just what change-makers need. I’m looking forward to developing relationships and continuing to work with the people I met there. For more information about Perinatal Quality Collaboratives, and to find your own state’s PQC in order to get involved, please check out this link: State Perinatal Quality Collaboratives.

About Melissa Sablack Gonzalez

Melissa Sablack Gonzalez, CD(DONA), LCCE, is a birth and postpartum doula and has been teaching Lamaze privately and in hospitals since 2010. She is the owner of Mesa Birth and is developing a startup business that provides resources to postpartum families. Melissa is a member of Lamaze International’s new Advocacy Committee. She lives in the suburbs of Chicago with her husband and two teenage sons and a sweet pit bull named Ruby. Everyone in her family loves babies. 

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