Maternal safety changes when we stop relying on heroics and start building systems. We open the door to the 2025 APSF Stolting Conference series with a fast, practical tour of what truly reduces morbidity and mortality: collaboration across anesthesia, obstetrics, cardiology, and nursing; open‑source AIM bundles; early warning tools; and standards that compress time-to-treatment when minutes matter. Along the way, we confront the three deadly D’s—denial, delay, dismissal—and replace them with teamwork, tools, timeliness, and trust.

We dig into the history that got us here, from case reports and confidential inquiries to robust maternal mortality review committees and rapid-cycle data that power real change. Then, we zero in on the leading cause of pregnancy-related death—cardiovascular disease—and why risk spikes in the postpartum period. A vivid case of peripartum cardiomyopathy shows how quickly decompensation unfolds and why anesthesia must be in the room early: shaping plans, managing hemodynamics, placing monitors, coordinating with cardiology and OB, and, when needed, activating ECMO. We highlight actionable steps like antenatal anesthesia consults for high‑risk patients, postpartum telemetry monitoring, and pregnancy heart teams that make escalation the rule, not the exception.

Progress is real for hemorrhage and hypertension, but disparities remain stark for Black, Hispanic, and Asian Pacific Islander patients. We talk about implicit bias, access, and respectful care, and we share multilingual urgent maternal warning signs so patients and clinicians recognize danger sooner. The ASA’s recommendations give a clear roadmap for anesthesiologist leadership—on review committees, quality teams, simulation programs, and implementation of SOAP and ACOG frameworks—so that safety becomes predictable.

If this conversation sparks ideas for your unit, we’d love to hear them. Subscribe, share with a colleague who works on labor and delivery, and leave a review telling us the one system change you’ll champion this month.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/276-maternal-care-transformed/

© 2025, The Anesthesia Patient Safety Foundation