WASHINGTON, D.C. — In a landmark move to address the persistent crisis of maternal mortality in the United States, the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) announced on July 14, 2026, that it has been awarded a $500,000 grant from Merck for Mothers. This significant financial injection is earmarked for the development and nationwide implementation of the POST-BIRTH Triage Index (PBTI), a pioneering standardized tool designed to transform how emergency departments (EDs), urgent care centers, and freestanding emergency facilities identify and treat postpartum complications.
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The initiative represents a critical evolution in maternal safety, moving beyond the labor and delivery suite and into the broader healthcare ecosystem where many postpartum complications first present. By equipping non-obstetric clinicians with specialized, validated tools, AWHONN aims to bridge a lethal gap in the American healthcare system that leaves many new mothers vulnerable after they leave the hospital.
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Main Facts: A Standardized Shield for the "Fourth Trimester"
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The $500,000 grant from Merck for Mothers—known as MSD for Mothers outside the U.S. and Canada—is specifically dedicated to the creation of the POST-BIRTH Triage Index (PBTI). While AWHONN has long been a leader in obstetric nursing, this project marks a strategic expansion into the realm of general emergency medicine.
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The PBTI Framework
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The PBTI is designed to be the first validated, postpartum-specific triage tool of its kind. Currently, when a patient enters an emergency department, they are typically assessed using the Emergency Severity Index (ESI) or similar general tools. However, these systems often fail to account for the unique physiological changes and high-risk indicators associated with the postpartum period, such as late-onset preeclampsia, postpartum hemorrhage, or cardiomyopathy.
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Strategic Implementation
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The grant will facilitate several key objectives:
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- The Establishment of a Multidisciplinary Expert Panel: Bringing together emergency physicians, obstetricians, nurses, and patient advocates to ensure the tool is both clinically rigorous and practical for fast-paced ED environments.
- Three-Phase Research Validation: Conducting rigorous studies to ensure the PBTI accurately identifies high-risk patients and improves clinical outcomes.
- Educational Resource Expansion: Developing comprehensive training modules for non-obstetric clinicians who may not have received specialized maternal health training since nursing or medical school.
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Chronology: From Warning Signs to Systemic Change
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The development of the PBTI is not an isolated event but the culmination of years of advocacy and data-driven research by AWHONN.
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The Success of PBWS (2014–2025)
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The foundation for this new initiative is AWHONN’s highly successful POST-BIRTH Warning Signs (PBWS) program. Launched over a decade ago, PBWS focused on patient education, teaching mothers how to recognize "red flag" symptoms—such as chest pain, seizures, or heavy bleeding—and empowering them to seek help. To date, the program reaches more than 1.7 million patients annually through discharge education and has been integrated into statewide maternal mortality prevention efforts across the country.
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Identifying the Gap (2024–2025)
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Despite the success of PBWS in getting mothers to the ER, AWHONN identified a secondary failure point: what happens once the mother arrives at the hospital. Research conducted across 23 emergency departments in 17 states revealed a startling inconsistency in care. Clinicians in non-obstetric settings often lacked the standardized protocols necessary to recognize that a patient’s headache might be a sign of life-threatening postpartum hypertension rather than a simple migraine.
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The 2026 Grant and Beyond
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With the awarding of the $500,000 grant in July 2026, AWHONN enters the implementation phase. Starting in late 2026, the organization will begin the multidisciplinary panel reviews and the first of three research studies. The goal is to have the PBTI integrated into electronic health records (EHR) and emergency protocols nationwide within the next three to five years.
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Supporting Data: The Urgent Reality of Postpartum Mortality
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The necessity of the PBTI is underscored by sobering statistics regarding maternal health in the United States. While much of the public focus remains on the act of childbirth itself, data suggests that the period after birth is actually the most dangerous for many women.
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The Mortality Window
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According to the Centers for Disease Control and Prevention (CDC) and supporting research cited by AWHONN, more than half of all pregnancy-related deaths occur between seven and 365 days postpartum. This period, often referred to as the "Fourth Trimester," is characterized by a significant drop-off in clinical supervision as mothers transition from frequent prenatal visits to a single six-week postpartum checkup.
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Preventability and Recognition
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Perhaps the most tragic aspect of these statistics is that the majority of these deaths are considered preventable. Research indicates that delays in diagnosis and treatment are primary contributors to maternal mortality. In non-obstetric settings, the lack of specialized training can lead to "diagnostic overshadowing," where postpartum symptoms are dismissed as normal recovery pains or exhaustion.
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The research conducted in the 23 emergency departments highlighted that:
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- Standard triage tools often underscore the severity of postpartum symptoms.
- Communication gaps between emergency departments and obstetric departments lead to delayed transfers of care.
- A significant percentage of ED clinicians expressed a desire for more specific guidance on managing postpartum emergencies.
Official Responses: A Shared Vision for Maternal Safety
Leadership from both AWHONN and Merck for Mothers emphasized that this partnership is a vital step toward systemic reform.
Jonathan Webb, CEO of AWHONN
Jonathan Webb, MBA, MPH, emphasized the vulnerability of the postpartum period. "This investment represents a significant step forward in improving maternal safety during one of the most vulnerable periods in a woman’s healthcare journey," Webb stated. "By developing the first validated postpartum-specific triage index for emergency and urgent care settings, we can help clinicians identify life-threatening complications more quickly, improve care coordination and ultimately save lives."
Webb further noted that the grant is not just about a tool, but about shifting the culture of emergency medicine to be more "obstetrically ready."
Jacquelyn Caglia, Head of Merck for Mothers
Representing the funding partner, Jacquelyn Caglia highlighted the alignment between AWHONN’s mission and Merck for Mothers’ global goal of ending maternal mortality. "Merck for Mothers believes that every mother deserves access to high-quality, timely care throughout the postpartum period," Caglia said. "We are honored to support AWHONN’s efforts to expand this important work, building on the success of the Post-Birth Warning Signs program and helping to strengthen systems providing care for families across the United States during this critical time."
Implications: Reshaping the Future of Healthcare
The introduction of the PBTI carries profound implications for the healthcare industry, nursing professionals, and American families.
For Healthcare Systems and EDs
The implementation of a validated triage index will likely lead to changes in hospital protocols. Hospitals may need to update their Electronic Health Record (EHR) systems to include PBTI prompts when a female patient of childbearing age presents at the ED. This "hard-wiring" of safety protocols ensures that the question "Have you been pregnant in the last year?" becomes a standard part of every intake, potentially saving thousands of lives.
For the Nursing Profession
As the primary users of triage tools, nurses stand to benefit significantly from the PBTI. For emergency department nurses, the tool provides a clear, evidence-based roadmap for decision-making. For obstetric nurses, it provides peace of mind that their patients will receive continuity of care even if they seek help at a facility without a dedicated labor and delivery unit.
Addressing Health Disparities
The maternal mortality crisis in the U.S. disproportionately affects women of color, particularly Black women, who are three times more likely to die from pregnancy-related causes than white women. By standardizing triage, the PBTI helps remove subjective bias from the initial assessment process. A standardized, data-driven tool ensures that every mother—regardless of race or socioeconomic status—is evaluated against the same rigorous clinical criteria.
Global Potential
While the current grant focuses on the United States, the development of a validated postpartum triage tool has global implications. Merck for Mothers operates in dozens of countries, and the lessons learned from the PBTI implementation in the U.S. could eventually serve as a blueprint for improving postpartum emergency care in other high- and middle-income nations facing similar challenges.
About the Organizations
AWHONN
The Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) is a 501(c)3 nonprofit membership organization. Its mission is to empower and support nurses caring for women, newborns, and their families through research, education, and advocacy. AWHONN is widely recognized as the voice of nursing in the field of maternal and child health, providing the standards of care that define the profession.
Merck for Mothers
Merck for Mothers is Merck’s global initiative to help create a world where no woman has to die while giving life. Utilizing Merck’s business and scientific expertise, the initiative collaborates with partners to improve the quality of maternal health services and address the barriers to care. Since its inception, Merck for Mothers has reached millions of women across the globe with programs designed to improve maternal health outcomes.
Media Contact:
Shannon Doolin
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