after the country confirmed its

Founded at Stanford University’s medical school in partnership with the state, it brings together people from every hospital with a maternity unit to share best practices on how to deal with issues that could lead to maternal injury or death, like high blood pressure, cardiovascular disease and sepsis.“When you look at the rate of maternal death in the United States compared to California, they basically ran neck-and-neck until it was established,” said Dr. Amanda Williams, clinical innovation adviser for the collaborative. “At that time they totally separated and California started going down. The rest of the country started going up.”

Denise Jones speaks with Dr. Allison Garnett during a prenatal appointment at the Oklahoma State University obstetrics and gynecology clinic. (AP Photo/Mary Conlon)Denise Jones speaks with Dr. Allison Garnett during a prenatal appointment at the Oklahoma State University obstetrics and gynecology clinic. (AP Photo/Mary Conlon)In the collaborative, hospitals get toolkits full of materials such as care guidelines in multiple formats, articles on best practices and slide sets that spell out what to do in medical emergencies, how to set up medical teams and what supplies to keep on the unit. The collaborative also tackles issues such as improving obstetric care by integrating midwives and doulas – whose services are covered by the state’s Medicaid program.

At first, some doctors resisted the effort, figuring they knew best, Williams said, but there’s much less pushback now that the collaborative has proven its value.MemorialCare Miller Children’s & Women’s Hospital Long Beach started participating around 2010. The collaborative helps “vet through all the research that’s out there,” said Shari Kelly, executive director of perinatal services. “It’s just so important to really understand how we as health care providers can make a difference.”

For example, if a woman loses a certain amount of blood after a vaginal delivery, “we know to activate what we call here a ‘code crimson,’ which brings blood to the bedside,” Kelly said. “We can act fast and stop any potential hemorrhage.”

She said the collaborative has also helped reduce racial inequities — bringing down the rate of cesarean sections among Black moms, for example.“We just ask everybody to find alternative pathways before phoning for an ambulance,” she said. “The ambulance service is for those who are experiencing life-threatening problems.”

Worrall’s craziest call came one afternoon when a man phoned to say his son’s pet alligator had escaped and was hiding under the sofa.“I asked if he’d been hurt, and he said, no. He was scared,” Worrall recounted.

He wanted paramedics to help him corral the toothy reptile.“I told him that we wouldn’t be sending an ambulance for something like that. And he said, ‘So you’re not going to send me any help until I get bit, is that right?’ I went, ‘That’s correct.’”