Overview

“The Alliance for Innovation on Maternal Health or AIM, is a national, cross-sector commitment designed to support best practices that make birth safer, improve maternal health outcomes and save lives” – AIM website

West Virginia is proud to have joined the AIM initiative in 2018 with support from the state Chapter of ACOG, AWHONN, WV Hospital Association, Office of Maternal Child and Family Health and the Bureau for Public Health. An AIM Task Force was created to oversee the efforts of the birthing hospitals in West Virginia. WV has implemented three patient safety bundles and continues to work on patient safety initiatives.

Currently, the Perinatal Partnership is coordinating efforts to implement the Severe Hypertension in Pregnancy Patient Safety Bundle and the Perinatal Mental Health Conditions Bundle in all 18 delivering facilities. Obstetric care providers and hospital staff have participated in emergency simulation drills and created policies and protocols to identify, diagnose and treat severe hypertension in pregnancy quickly and effectively. Hospital teams participate in monthly networking meetings to help support bundle implementation.

The AIM Task Force, formed in 2018, provides guidance to the hospital AIM teams to integrate the safety bundles into their perinatal care setting. Currently, the AIM Task Force is led by Melanie Riley, RN, MSN, Director of Clinical Programs for the Perinatal Partnership. The task force is co-chaired by Emily Sloane, MD of the Joan C. Edwards School of Medicine, Marshall University and Megan Radcliff, MSN, APRN, FNP-C, PMHNP-BC, PMH-C. Other members of the task force include nurse managers, WV Hospital Association staff, and other stakeholders.

West Virginia has implemented three patient safety bundles since becoming an AIM state in 2018. Throughout the implementation of the AIM initiatives, the overall Severe Maternal Morbidity rate has been maintained at or less than 1%, and currently the rate is 0.8% for 2025.

100 %

Birthing hospitals in WV participate in the AIM initiatives
83 %

Birthing hospitals in WV that had a Severe Maternal Morbidity rate less than the state rate of 0.8% in 2025
1 in 4

Women giving birth in WV also had a perinatal mental health condition identified

Obstetric Hemorrhage

In response to high rates of severe maternal morbidity (SMM) due to hemorrhage, in 2018, the West Virginia Perinatal Partnership began implementation of the AIM Obstetric Hemorrhage patient safety bundle in 22 of the 23 birthing facilities in the state. Since initiation of the hemorrhage bundle, Severe Maternal Morbidity for patients experiencing Obstetric Hemorrhage has decreased 42%, down to 4.7% in 2025.

  • 90% of hospitals have provided education to nurses and providers on respectful care and obstetric hemorrhage.
  • 85% of obstetric units are using quantitative blood loss measurement, and 95% use a hemorrhage risk assessment tool to identify at risk patients.
  • 100% of hospitals are providing patients with information on urgent post birth warning signs prior to discharge.

For more information on the AIM Patient Safety Bundle – Obstetric Hemorrhage, including implementation guides and resources go to saferbirth.org.

For more information about West Virginia’s work on obstetric Hemorrhage, contact Melanie Riley at rileym@marshall.edu

98 %

Hospitals that have implemented a hemorrhage risk assessment process
89 %

Hospitals that use quantitative blood loss for early detection of hemorrhage.
3 / 4

West Virginia hospitals continue to input data into the AIM portal for performance monitoring

Severe Hypertension in Pregnancy

Currently, the Perinatal Partnership is coordinating efforts to implement the Severe Hypertension in Pregnancy Patient Safety Bundle and the Perinatal Mental Health Conditions Bundle in all delivering facilities. Obstetric care providers and hospital staff have participated in emergency simulation drills and created policies and protocols to identify, diagnose and treat severe hypertension in pregnancy quickly and effectively.

In 2025, data for the implementation of the Severe Hypertension in Pregnancy bundle indicates:

  • Severe Maternal Morbidity for patients experiencing Severe Hypertension in pregnancy was 4.3% in 2025
  • Achievements:
    • Since 2016 baseline – hospitals have decreased maternal morbidity related to severe hypertension by 54%.
    • >90% of providers and nurses have received education on respectful care and hypertension in pregnancy.
    • >80% of hospitals are regularly doing patient debriefs, team debriefs, multidisciplinary case reviews, and providing patient support after a severe hypertensive episode.

For more information on the AIM Patient Safety Bundle – Severe Hypertension in Pregnancy go to saferbirth.org.

For more information about West Virginia’s work on hypertension in pregnancy, contact Melanie Riley at rileym@marshall.edu

1 %

The average rate of Severe Maternal Morbidity in WV is 1% or less, below the national average of 1.1%
100 %

West Virginia has full participation of all birthing facilities in the AIM Patient Safety Initiative
2 / 3

West Virginia birthing facilities have implemented policies for recognizing and treating severe hypertension in pregnancy

“Statistics don’t tell us about the people. Even one mother who experiences obstetrical complications that could have been prevented, is too many. I’m not willing for that to be any family’s loved one. Every woman has the right to safe, equitable care that meets the needs of her and her family.”

 

– Melanie Riley, RN NE-BC MSN, Nurse Coordinator

Perinatal Mental Health Conditions

In 2024 WV initiated the launch of the Perinatal Mental Health Conditions Patient Safety Bundle. According to hospital discharge data, approximately 1 in 4 women delivering a baby in WV has experienced a perinatal mental health condition. This rising rate of occurrence and recognition of the importance of maternal mental health for the wellbeing of not only the mother, but the newborn and the family unit, prompted the statewide efforts of the WV Maternal Mental Health Advisory Council and the implementation of the AIM Patient safety bundle for perinatal mental health conditions.

Since initiation of the bundle implementation, the following accomplishments for 2025 include:

  • 95% of providers and staff have had education on perinatal mental health conditions and respectful care. Many participated in the Perinatal Mood and Anxiety Disorders training from Postpartum Support International.
  • 93% of patients giving birth received information on perinatal mental health conditions and post birth warning signs prior to discharge.
  • Hospitals and prenatal care practices are working to track screening for PMHC, referrals to treatment and post discharge follow up.
  • Expanded resource lists and community support organizations have been identified.

For more information on the AIM Patient Safety Bundle – Perinatal Mental Health Conditions go to saferbirth.org.

For more information on the WV Maternal Mental Health work check out the webpage under our initiatives or click here.

New simulation models for on-site OB Emergency Simulation Trainings.

In situ simulation training has been proven to improve team recognition and response to obstetrical emergencies. Throughout the bundle implementations, providing OB simulation trainings has been encouraged and supported through on site training and resources.

For more information about OB Simulation Training please contact Mary Beth Stewart at mbstewart@wvperinatal.org.

For information on the Obstetrical Complications in the ED on site training, click here.

For any questions about the AIM bundle implementation process in WV, contact:

Melanie Riley, RN, MSN – rileym@marshall.edu