At a Glance
- Maternal deaths in the year after pregnancy more than doubled between 1999 and 2019.
- Labor nurse says one question before admission can flag safe vs. unsafe care.
- AWHONN recommends one nurse per laboring patient; many units exceed that load.
Why it matters: Unsafe staffing is linked to higher complication and mortality rates for birthing parents.
A labor and delivery nurse is urging expectant families to ask a single question before choosing a hospital: does the unit follow AWHONN safe-staffing standards? According to News Of Philadelphia‘s investigation, the number of U.S. women who died in the year following a pregnancy more than doubled between 1999 and 2019, and the nurse believes chronic understaffing is a key driver.
“If you or someone you love is going to give birth in a hospital, there is a question you need to ask before you go that can determine whether you are likely to have safe care or not,” Jen Hamilton said. Her multi-part TikTok videos drew a combined 300,000 views in their first 24 hours.
AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses, publishes a 95-page evidence-based guide that recommends a nurse care for no more than two patients at a time, with one-to-one care preferred for active labor. Hamilton, who is writing the book Birth Vibes, told News Of Philadelphia she hears “these stories from other nurses who work in places where unsafe staffing is the norm.”
How to Check Hospital Ratios
- Ask friends or parent Facebook groups for contacts on the labor unit.
- Post: “How often are you asked to care for more than two patients?”
- Contact the unit directly; avoid the main hospital switchboard.
Hamilton suspects some hospitals will be “furious” at her public campaign but insists transparency is vital. “I believe that if we’re living in a country that has the highest maternal mortality rate in any developed nation, that having unsafe staffing is a big contributor to this,” she said.
An AWHONN spokesperson confirmed to News Of Philadelphia that while there “is not a single universal ratio,” the group generally recommends one nurse per patient in active labor, citing “numerous studies” linking inadequate staffing to higher inpatient mortality and adverse events.
What to Do if You Arrive and Find Unsafe Ratios
If your nurse is already juggling more than two laboring patients, Hamilton advises asking for the house supervisor and requesting two actions:
- Ask whether hospital administrators know the unit is understaffed.
- Demand that your chart note you are being cared for by a nurse with an “unsafe assignment.”
“Automatically points a finger at the unsafe staffing, that the hospital knew and did not do anything about it,” Hamilton said. She emphasized never to blame the nurse, who is simply doing the job assigned.
Comments from other nurses on her video suggest documentation triggers rapid action:
- “Sooooo fast. Admin on call’s phone would be ringing.”
- “I tell management I’m not even clocking in if it’s unsafe.”
- “They would be offering big money to come on – that they didn’t have two hours earlier.”
Can You Switch Hospitals Mid-Labor?
Hamilton calls the decision “personal.” If you are at the hospital for a non-medical induction, “there’s always an option to leave,” she said, adding that families must weigh individual risk versus benefit.
Because active labor limits a patient’s ability to advocate, Hamilton urges sharing the staffing question with partners, doulas, or other support people so they can speak up on the birthing parent’s behalf.
The campaign follows rising concern over U.S. maternal health outcomes. Between 1999 and 2019, deaths within a year of pregnancy more than doubled, placing the United States at the top of developed-nation mortality statistics. Hamilton contends proper nurse-to-patient ratios could curb that trend.
This story first appeared on News Of Philadelphia.
