About Obstetric Sepsis

Obstetric sepsis is now the second-leading cause of maternal mortality. It is also the primary cause of severe maternal morbidity during both the antepartum and postpartum periods, and the third-leading cause at delivery. Data from the California Pregnancy Associated Mortality Review (CA-PAMR) committee report estimate that 63% of maternal deaths from sepsis had a good or strong chance to have been preventable. Furthermore, for each maternal death, there are 50 women/birthing people who experience life-threatening morbidity from sepsis. This is concerning, given that prompt recognition and rapid treatment of pregnant and postpartum women/birthing people with sepsis usually results in good outcomes in this young and generally healthy population.

To assist healthcare providers in implementing evidence-based methods for timely recognition and treatment of sepsis, a community co-designed and co-led quality improvement collaborative for obstetric sepsis was launched in two states (California and Michigan). CMQCC partnered with the Dunlevie Maternal-Fetal Medicine Center at Stanford School of Medicine, Michigan Alliance for Innovation On Maternal Health (AIM), and Duke University to increase the impact of this effort.

The Obstetric Sepsis Collaborative (Oct. 2023-Dec. 2024) engaged mentor-led groups of six to ten hospitals. Each group had four mentors including a nurse, physician, community leader, and a patient with lived experience who added a unique perspectives on this work. The Community Leadership Group and the Clinical Advisory Board, in partnership with project leadership, developed a number of resources that will advance the care of patients with obstetric sepsis.  Many also address generalizable issues for all severe obstetric complications. These resources are available below.

  • Advocacy Tips for Patients and Families
  • Guide for Patient and Family Debriefs before Discharge
  • Obstetric Sepsis Flow Chart for Screening and Diagnosis
  • Urgent Maternal Warning Signs (developed by AIM/ACOG and the CDC)
  • Warning Signs Follow-up Guide for Health Care Professionals

 

Improving Diagnosis and Treatment of Maternal Sepsis Toolkit

"Improving Diagnosis and Treatment of Obstetric Sepsis, V2.0 Toolkit" was developed by the Sepsis Task Force Advisory Group and published in September 2025 as a resource for obstetricians, rapid response teams, and intensive care units who interact with women and birthing people during pregnancy and in the postpartum period. The toolkit introduces a new two-step screening and confirmation process to more accurately diagnose and treat obstetric sepsis. This screening and diagnostic approach has been updated as part of the NICHD-supported Obstetric Sepsis Collaborative active in California and Michigan. As part of the review process for the collaborative, the sepsis toolkit has been reviewed and updated to recognize:

  • Updates on screening
  • New and improved obstetric antibiotics
  • Infectious Diseases Society of America’s updated sepsis guidelines
  • Patient and provider resources from national obstetric organizations focused on Maternal Urgent Warning Signs, patient advocacy support, and clinician listening tips

Download Improving Diagnosis and Treatment of Obstetric Sepsis, V2.0 Toolkit (2025)

Beginning April 30, toolkits and related resources on our website will require a CMQCC Account login. You will be prompted to log in or create an account. After you’ve logged in, you’ll automatically see an option to complete the download. Questions or need help? Email us at info@cmqcc.org. (Note: This is a different email than for MDC support!)

Individual sections of the toolkit are also available for download:

 

Key Resources

Webinars (2025)

Sepsis Collaborative Webinar Series (2023-2024)

 

Related Publications: Sepsis Quality Improvement Collaborative

 

Funding Acknowledgement

Funding for the joint California and Michigan Obstetric Sepsis QI Collaborative is provided by a cooperative agreement with NICHD (UH3-HD108053).