Maternal Early Warning System

The Maternal Early Warning System (MEWS) initiative seeks to implement a protocol into practice to facilitate timely recognition, diagnosis, and treatment for pregnant women developing critical illness, thus avoiding major morbidity and mortality. Essential components of an early warning system include: 1) maternal early warning criteria that prompt reporting to a clinician; and 2) an effective notification and escalation process that prompts bedside evaluation by a clinician. The MEWS initiative is an integral component of TexasAIM, which is coordinated by the Texas Department of State Health Services (DSHS). TCHMB provides MEWS technical assistance to all TexasAIM hospitals.  






Learning Collaborative

Maternal death in the United States is “just the tip of the iceberg.”For every maternal death, 100 women experience severe maternal morbidity (SMM). SMM refers to unexpected outcomes of the process of labor and delivery that result in significant short- and long-term consequences to a woman’s health. According to a recent report, SMM prevalence in Texas in 2016 was 17.0 per 1,000 deliveries. A substantial proportion of SMM is potentially preventable and, thus, can be targeted as a means of preventing maternal mortality.

The MEWS learning collaborative is working on implementing a MEWS protocol to increase the early recognition of changes in a mother’s vital signs and clinical conditions leading to effective escalation and prompt evaluation with the goal of reducing the number of women experiencing obstetrical hemorrhage, hypertension, or other severe maternal morbidities.


Obstetrics Subcommittee Co-Chairs

Christina Davidson, MD, Baylor College of Medicine

Catherine Eppes, MD, MPH, Baylor College of Medicine

Project Leads

Divya Patel, PhD, UT Health Science Center at Tyler, Affiliate of The University of Texas System

Amanda Wagner, MSN, WHNP-BC, UT Health Science Center at Tyler, Affiliate of The University of Texas System