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Maternal Health Emergency Department Toolkit

  • Illinois Maternal Mortality Review Committees (MMRCs) found that, from 2018-2020, 91% of pregnancy-related deaths were potentially preventable.1

  • Of the people in Illinois who experienced a pregnancy-related death from 2018-2020, 66% had at least one ED visit with an average of 3.5 visits.1

1Illinois Department of Public Health. Illinois Maternal Morbidity and Mortality Report. 2023 October.

You can be part of the solution! Heading link

The Maternal Health Emergency Department Toolkit training was created by a Task Force of 33 experts to fill the gaps in maternal health care education for emergency departments. The Toolkit training consists of five educational modules including didactic information, case-based learning, and resources for additional reading and local implementation. The modules focus on recommendations from the Illinois MMRCs, triage and management of emergencies in perinatal patients, screening and treatment of mental health and substance use conditions, addressing trauma during pregnancy, performing resuscitation during pregnancy, and conducting safe and coordinated discharge of perinatal patients from the emergency department.

The Toolkit training was piloted at six hospitals from May 2023-June 2024 where it was established as evidence-based.

Read about the development of the Toolkit in our recent publication, Development of a Maternal Health Toolkit for Emergency Department Education in Illinois. The results from the pilot program are forthcoming.

The Maternal Health Emergency Department Toolkit is now available for all emergency departments in Illinois!

If you are not affiliated with an Illinois hospital and want to access the training or want to submit an inquiry, fill out this form. We are currently preparing to release the training to the public.

Critical Success Factors in the Emergency Department Heading link

  • Display a sign in your ED alerting patients that they should inform ED staff of their pregnancy or postpartum status.
  • Ask persons of reproductive age (10-55 years) if they are pregnant or within one year postpartum.
  • Document their pregnancy or postpartum status in the patient’s chart. For example, if available, check the EMR box for pregnant or postpartum status, or add a note to the chart.
  • Treat patients who are pregnant or within 1 year postpartum in accordance with the guidelines in the Toolkit modules.

Training Content Heading link

The entire training takes 4 hours to complete, but it does not need to be completed in one sitting. Each module can be paused and will pick up where you left off.

Training Modules

  • Introduction: Maternal Health Emergency Department Toolkit Training
  • Module A: Introduction to Maternal Mortality in Illinois: How Emergency Departments Can Help
  • Module B1: Acuity Assessment and Management of Perinatal Emergencies
    • Module B2: Jamie
    • Module B3: Maya
    • Module B4: Carrie
    • Module B5: Jessica
    • Module B6: Marie
  • Module C: Screening for Perinatal Mental Health and Substance Use Disorders
  • Module D: Trauma and Resuscitation in Pregnancy
  • Module E: Best Practices for Pregnant and Postpartum Patients Being Discharged from the Emergency Department

An brief overview of the training is also available in the Maternal Health Emergency Department Toolkit Content handout.

All resources mentioned in the training can be found in the Maternal Health ED Toolkit Resource Library.

The following provides an overview and learning objectives for each module. At the end of each module, make sure to download the 1-page summary!

Module A: Introduction to Maternal Mortality in Illinois: How Emergency Departments Can Help

Module A outlines the current state of maternal health in Illinois. It provides a thorough explanation of where the data comes from, how emergency departments play a key role in the care of pregnant and postpartum patients, and what we can do together to help improve maternal health in Illinois.

Estimated time to complete: 14 minutes

Module A Learning Objectives

  1. Describe the Illinois maternal mortality review process.
  2. Describe the prevalence of emergency department use among Illinois maternal deaths.
  3. Discuss the opportunities for emergency departments.
  4. List the recommendations for emergency departments to address maternal health.

Module B: Acuity Assessment and Management of Perinatal Emergencies

Using a Respectful Maternity Care approach, Module B combines the Emergency Severity Index, Early Obstetric Warning Signs, and the Maternal Fetal Triage Index into the Perinatal Triage Algorithm for the triage of pregnant and postpartum patients in the emergency department.

Module B contains an introduction (B1) and 5 case studies (B2-B6). Case studies cover common emergent obstetric conditions.

We recommend having the Perinatal Triage Algorithm printed or open on your device while working through the Module B case studies.

The entire Toolkit training requires 4 hours and does not need to be completed in one sitting. Each module can be paused and will jump back in to where you left off.

Estimated time to complete: 133 minutes

Module B Learning Objectives

  1. Explore how to incorporate perinatal patients into an emergency department acuity system.
  2. Identify the Obstetric Warning Signs.
  3. Consider how to integrate knowledge and apply skills in the recognition and management of the compromised obstetric patient.

Module C: Screening for Perinatal Mental Health and Substance Use Disorders

Module C discusses the best practice for conducting universal screening for depression, anxiety, suicide risk, substance use disorders (SUD) and opioid use disorder (OUD). Module C also shares guidance on assessing the need for in-patient level of care for safety concerns and stabilization. Module C includes key resources to support perinatal patients in Illinois.

Estimated time to complete: 31 minutes

Module C Learning Objectives

  1. Recognize how to conduct universal screening for depression, anxiety, and suicide risk.
  2. Understand how to respond to pregnant and postpartum patients with depression, anxiety, and suicide risk.
  3. Recognize how to conduct universal self-report screening for substance use disorder and opioid use disorder.
  4. Understand how to respond to pregnant and postpartum patients with substance use disorder and opioid use disorder.

Module D: Trauma and Resuscitation in Pregnancy

Module D shares guidance for treating pregnant patients who have experienced trauma. Module D discusses best practices for treating trauma in pregnancy, including early warning signs of various instances of trauma, and how to address the warning signs for the best possible outcome of both the pregnant person and the fetus.

Estimated time to complete: 28 minutes

Module D Learning Objectives

  1. Demonstrate the procedure for continuous uterine displacement during CPR of a pregnant person.
  2. Recognize potential etiologies of maternal cardiac arrest. Cite examples of pregnancy-related anatomic and physiological changes that affect management of an injured pregnant persons.
  3. Outline the timeframe and criteria for when to perform a perimortem cesarean section during management of cardiac arrest of a pregnant person.
  4. Explain the two outcome goals for performing a perimortem cesarean section.

Module E: Best Practices for Pregnant and Postpartum Patients Being Discharged from the Emergency Department

Module E goes through the best practices for emergency department discharge, care coordination, recommended follow-up time for select conditions, and provides key resources for pregnant and postpartum patients.

Estimated time to complete: 12 minutes

Module E Learning Objectives

  1. Determine follow-up time after discharge from the emergency department.
  2. Complete Discharge Checklist.
  3. Engage in hand-off and provide care coordination.
  4. Provide patient with resources.

Access the Training Heading link

You can access the training at publichealthlearning.com or the training may be available on your hospital’s learning management system (LMS) platform.

How to access the training

  1. Visit publichealthlearning.com
  2. Create an account
    • Receive a confirmation email from PublicHealthLearning.com
    • Note: If you are not receiving emails from the site, they may be going to your SPAM or Junk email folder.
  3. Click “Course Offerings”
  4. Select the course “Maternal Health Emergency Department Toolkit”
  5. Begin!

Navigating the course

  1. Select the folder icon to access the content for each section.
  2. Finish all modules to complete the training.

For further instructions, visit the Maternal Health Emergency Department Toolkit Public Health Learning LMS Guide. This guide is specific to this course.

The PublicHealthLearning User Guide is also available. This general guide provides more detailed information about navigating the PublicHealthLearning platform.

Still have questions?

Contact the UIC CRWG Team Members.

Why Should I Take this Training? Heading link

Receive free CME credits.
Those who complete the Maternal Health Emergency Department Training using the central LMS on publichealthlearning.com can elect to receive 4 free Continuing Medical Education (CME) credits. CME credits are accepted by the American Nurses Credentialing Center (ANCC) and other professional accreditation organizations.

Fulfill training requirements.
The Maternal Health Emergency Department Toolkit training fulfills existing training requirements for emergency departments in Illinois.

  • Title 77: Public Health, Chapter I: Department of Public Health, Subchapter b: Hospitals and Ambulatory Care Facilities, Part 250 Hospital Licensing Requirements, Subpart O
  • Public Act 101-0309 requires all birthing facilities to conduct annual continuing education on maternal hypertension and obstetric hemorrhage, addressing airway emergencies experienced during childbirth, and management of other leading causes of maternal mortality for units that care for pregnant or postpartum women. All obstetric, emergency departments, and other staff that care for pregnant and postpartum women must complete the training requirement.
  • CMS-1809: require all emergency departments must provide training on maternal health. Read more about CMS-1809 on GovInfo.gov and CMS.gov.
  • ILPQC Perinatal Mental Health (PMH) Initiative starting in May 2025 for Illinois birthing hospitals. The PMH Initiative includes required training on mental health conditions and substance use disorders for emergency department physicians and nurses.

Upcoming Initiative for Illinois Birthing Hospitals Heading link

The Illinois Perinatal Quality Collaborative (ILPQC) will be launching the Perinatal Mental Health (PMH) Initiative in May 2025. This program will provide support for outpatient, obstetric and emergency medicine nurses and physicians at birthing hospitals in Illinois. The PMH Initiative aims to promote screening, treatment and linkage to resources for perinatal mental health conditions and substance use disorders. More information to follow!

This training was brought to you by the University of Illinois Chicago College of Medicine Center for Research on Women and Gender, Illinois Department of Public Health, Illinois Regional Administrative Perinatal Centers, and Task Force members who developed the Toolkit.

A special thank you to the emergency departments in Illinois for their dedication to improving care for pregnant and postpartum patients.

This project was funded by the Illinois Department of Public Health Maternal and Child Health Title V Block Grant.

Citation:
University of Illinois Chicago College of Medicine Center for Research on Women and Gender, Illinois Department of Public Health, Illinois Regional Administrative Perinatal Centers. Maternal Health Emergency Department Toolkit. 2025.

Resources Heading link