A case of obstetrical hemorrhage due to uterine atony, requiring medical and surgical interventions and blood component replacement therapy is presented. Emphasis: A review of obstetrical hemorrhage, etiologies, and treatments is provided. The importance of early recognition and response to excessive blood loss is stressed. Medical and surgical interventions for uterine atony are reviewed. Current recommendations for blood component replacement therapy for massive hemorrhage are discussed.

Intrapartum fetal heart rate monitoring is an integral part of modern day obstetrics and when properly interpreted, may provide valuable insight into the fetal metabolic state. During labor, the physiologic stress posed by regular uterine contractions and maternal expulsive efforts may adversely impact the fetal acid-base status, leading to changes in the fetal heart rate pattern.

This module aims to review and apply essential FHR content in several clinical scenarios to highlight an important Clinical Pearl: Management of the laboring patient requires that the FHR pattern trends are interpreted in context with the clinical scenario and progress of labor.

Two cases are presented. Risk factors, including recurring and nonrecurring, for obstetrical hemorrhage, are reviewed. Delivery preparations and preventative strategies are discussed. Methodologies that better quantify blood loss, allowing for earlier recognition of excessive blood loss, are presented. Management of the patient experiencing obstetric hemorrhage, including a review of current guidelines for blood component replacement therapy, are reviewed.

The Healthy People 2030 campaign categorizes social determinants of health (SDOH) into five domains and each one has an impact on health outcomes and informs best practices in the delivery of healthcare (U.S. Department of Health and Human Services, n.d.). This course provides practice scenarios for use of a rapid assessment tool for screening patients for social determinants that impact their health.

Economic stability is defined as a domain of social determinants of health in the Healthy People 2030 campaign. It relates to an individual’s ability to access resources such as food, adequate housing, and healthcare. Each component of economic stability, including poverty, employment, food security, and housing stability, is linked to individual health outcomes.

Education access and quality is a pillar of the social determinants of health for Healthy People 2030 (U.S. Department of Health and Human Services, n.d.). This course outlines the effects of education on an individual’s health. The four components of education access and quality include early childhood education and development, high school graduation, enrollment in higher education, and language and literacy.

All healthcare professionals must be aware of bias and the challenges that bias can create in healthcare. This includes knowing some of the challenges people face with the healthcare system. In this course, you will learn best practices to help recognize and manage bias.

Cultural competence in healthcare refers to the delivery of quality care. It refers to meeting the needs of people with disabilities, members of the LGBTQ+ community, and those from diverse socioeconomic and cultural backgrounds. Cultural competence must be a two-way system to benefit people with differing beliefs, attitudes, values, and behaviors. This course discusses cultural competence and how organizations can use cultural competency to create an atmosphere of inclusion.

This course provides an overview about the safety of patients undergoing a trial of labor after cesarean (TOLAC) to attempt a vaginal birth after cesarean delivery (VBAC). Research evidence has influenced where VBACs are performed, which women are eligible and how the practice is conducted, including the safe use of induction/augmentation medications. The safety of VBAC for mother and newborn always remains the primary underlying principle that guides care.