Recommendations to the IHS from the Rural Maternal Safety Meeting

The multidisciplinary Rural Maternal Safety working group met on August 4, 2014 to develop recommendations for ensuring safety in low birth volume facilities. The following are the recommendations to the Indian Health Service (IHS) based upon the extensive breadth and depth of the experience of the nationally recognized participants in the provision of skilled maternity and newborn care in rural and remote settings such as at a number of the smaller IHS and Tribal hospitals and clinics.

1. Collaboration

2. Prenatal Care

3. Regionalization of Maternity and Newborn Care

4. Low Risk IHS and Tribal Rural Birthing Centers

5. Nurse Staffing Requirements

6. Clinical Case Reviews

7. Skills and Training


This report represents recommendations of the national multidisciplinary working group that was convened in consultation to the Indian Health Service to assure optimal outcomes of obstetric and neonatal care in rural IHS and Tribal health care settings. The working group acknowledges that these are the initial steps and a foundation towards making maternal care in rural remote settings safe for women and their children. We look forward to the continued dialogue and development of these recommendations with the IHS. We also note that much of the information in this report can be extrapolated to other rural and global areas facing similar circumstances such as in the IHS. The multidisciplinary working group looks forward to continuing its efforts in these areas as well.

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