The “Checklist,” That May Save Pregnant Black Women

As a maternal-fetal medicine specialist, the fact that the United States has the highest rate of pregnancy-related deaths compared to other developed countries deeply concerns me. Yet, more shocking to me is the level of disparity in the rate of maternal death. A black woman is three times more likely to die from pregnancy-related complications than a white woman. What can be done about this disparity? Is the postpartum checklist the answer?

For several decades, the aviation industry has successfully implemented checklists for routine and emergency situations to ensure the safety of the plane and all of the precious lives it carries. Following the example of the aviation industry, many have endorsed the routine use of checklists to ensure safe and quality care in medicine.

The well-known physician and author, Atul Gawande, makes the case for the implementation of checklists in Medicine in his acclaimed book, “The Checklist Manifesto.” Has the checklist been shown to work in Medicine? Yes, it has. The use of the WHO Surgical Safety Checklist by most surgical providers around the world has significantly reduced both morbidity and mortality.

In an effort to prevent errors and ensure standardization of care, the use of surgical checklists has become routine in Obstetrics. Besides surgical checklists, obstetricians use checklists for treatment of hemorrhage, high blood pressure, and seizure, to name a few. Under intense stressful situations, checklists reduce the variations in practice that could put the patient’s life at risk.

In other words, a checklist may allow a physician to ensure that no important step is forgotten and that procedures and treatments are performed in an acceptable and timely fashion regardless of the location or size of the hospital or clinic.

A checklist may improve communication among healthcare providers of