UAMS Study Reveals Gaps in Obstetric Emergency Preparedness in Arkansas Emergency Departments
| LITTLE ROCK — A study from the University of Arkansas for Medical Sciences (UAMS) finds that while obstetric emergencies are common in Arkansas emergency departments (EDs), many hospitals lack key protocols, training and capabilities needed to manage life-threatening maternal complications.
UAMS researchers surveyed managers from 51 EDs, representing 61% of all hospital-based EDs statewide, to evaluate their experiences, capabilities and training related to obstetric emergencies. In the previous year, 43% of EDs reported a birth, 71% managed urgent transports of pregnant or postpartum patients, and nearly half experienced an unanticipated adverse maternal outcome.
Despite the frequency of obstetric cases, the study found:
- Only 31% of EDs required documentation of pregnancy status in the electronic health record.
- 46% had no field to record postpartum status — an important gap given that many maternal deaths occur after delivery.
- Fewer than half (46%) had provided any obstetric emergency training in the past two years.
“These numbers reinforce that every ED in the state — whether or not it has labor and delivery services — must be prepared to manage obstetric emergencies,” said Jennifer Callaghan-Koru, Ph.D., associate professor in the UAMS College of Medicine’s Department of Obstetrics and Gynecology and executive director of the Arkansas Perinatal Quality Collaborative. Callaghan-Koru is also an associate professor in the Department of Health Behavior and Health Education in the Fay W. Boozman College of Public Health.
Even hospitals without obstetrics units frequently care for high-risk patients, particularly in rural areas where more than 60% of Arkansas counties lack obstetric services. Differences in preparedness may contribute to maternal health inequities in Arkansas, a state with one of the highest maternal mortality rates in the nation.
Faculty at UAMS are already working to address the gaps identified in this study through the Arkansas Perinatal Quality Collaborative (ARPQC). Luann Racher, M.D., associate professor of Obstetrics & Gynecology at UAMS, develops and leads trainings for ED staff and emergency medical services throughout the state with the ARPQC.
“We are preparing ED staff to manage complications like pregnancy-related hypertensive emergencies, precipitous birth and postpartum hemorrhage through skills-based simulation trainings and standardized clinical algorithms,” Racher said.
Racher emphasized that improving emergency preparedness is essential in both hospitals with and without obstetric services — particularly as rural maternity units continue to close nationwide.
She noted that interest in training is strong among ED leaders, signaling readiness for statewide efforts to improve emergency preparedness and reduce maternal mortality.
“This level of interest demonstrates that ED leaders recognize the need and are motivated to strengthen maternal care across Arkansas,” Racher said. “We are proud of the Arkansas Perinatal Quality Collaborative’s ability to meet this need and support high-quality emergency medical care.”
UAMS is the state’s only health sciences university, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; a hospital; a main campus in Little Rock; a Northwest Arkansas regional campus in Fayetteville; a statewide network of regional campuses; and eight institutes: the Winthrop P. Rockefeller Cancer Institute, Jackson T. Stephens Spine & Neurosciences Institute, Harvey & Bernice Jones Eye Institute, Psychiatric Research Institute, Donald W. Reynolds Institute on Aging, Translational Research Institute, Institute for Digital Health & Innovation and the Institute for Community Health Innovation. UAMS includes UAMS Health, a statewide health system that encompasses all of UAMS’ clinical enterprise. UAMS is the only adult Level 1 trauma center in the state. UAMS has 3,553 students and 902 medical residents and fellows. It is the state’s largest public employer with about 12,000 employees, including 1,200 physicians who provide care to patients at UAMS, its regional campuses, Arkansas Children’s, the VA Medical Center and Baptist Health. Visit www.uams.edu or uamshealth.com. Find us on Facebook, X (formerly Twitter), YouTube or Instagram.###