Obstetrical emergencies are some of the most complex and high-stakes situations encountered in the emergency room. Two patients are involved. Time is critical. Emotions run high. Success depends not only on clinical expertise, but on how well a diverse group of professionals can function as one coordinated team.
Emergency physicians, obstetricians, nurses, anesthesiologists, neonatologists, midwives, respiratory therapists, and support staff may all converge within minutes. When teamwork breaks down, care suffers. When teamwork is strong, outcomes improve for both mother and baby.
A Case from the Emergency Room
A 32-year-old woman, 38 weeks pregnant, arrives by ambulance with heavy vaginal bleeding and abdominal pain. She is pale, tachycardic, and hypotensive. The fetal heart rate tracing is concerning. Within moments, the emergency room fills with people to help with her care.
The emergency physician initiates IV fluid resuscitation and clearly announces themselves as team lead until obstetrics arrives. A nurse establishes large-bore IV access and blood products are ordered. Another nurse places the patient on continuous fetal monitoring.
When the obstetrician arrives, leadership transitions smoothly with a brief verbal handoff summarizing the patient’s condition and the interventions already in progress.
Anesthesia is consulted early. Neonatology is alerted in anticipation of an emergent delivery. A short team huddle confirms the working diagnosis of placental abruption, the plan for rapid transfer to the operating room, and each team member’s role. The patient is moved quickly, decisively, and safely.
This is what effective multidisciplinary teamwork in obstetrical emergencies looks like in real time.
Start with Clear Leadership and Role Definition
In any emergency, someone must lead. In obstetrical emergencies, confusion can arise when teams from multiple departments arrive at the same time.
Effective teams establish:
- A clearly identified team leader
- Explicit role assignments early in the resuscitation
- A shared understanding of responsibility for maternal care, fetal monitoring, airway management, medications, and documentation
Leadership may shift as additional specialists arrive, but transitions should always be explicit and verbalized so that no information is lost.
Use Structured Communication
Miscommunication is a leading contributor to medical error, particularly in high-acuity situations.
Closed-loop communication ensures that critical orders are heard, acknowledged, and completed. Brief updates keep everyone aware of changes in the patient’s condition. Standardized language helps convey urgency without ambiguity.
When communication is structured, teams move faster and with greater confidence.
Train Together Before the Crisis
Obstetrical emergencies may be rare, but when they occur, there is no time to figure out how to work together.
Multidisciplinary simulation training allows teams to:
- Practice high-risk obstetrical scenarios in a safe environment
- Clarify roles and expectations across disciplines
- Identify hidden safety threats in workflows or equipment
Teams that train together are more likely to remain calm, coordinated, and effective when a real patient arrives.
Create a Culture of Psychological Safety
During emergencies, the quietest voice in the room may notice the most important detail. Teams perform best when every member feels empowered to speak up.
Psychological safety is supported when:
- Leaders actively invite input from all team members
- Questions and concerns are welcomed
- Hierarchy does not prevent escalation of safety issues
In obstetrical emergencies, speaking up can be lifesaving.
Align on Shared Mental Models
A shared mental model means the entire team understands what is happening now and what is likely to happen next.
Even brief huddles lasting less than a minute can clarify:
- The working diagnosis
- Immediate priorities
- Anticipated complications and next steps
In the case above, a short huddle aligned the team around the need for emergent delivery and reduced delays and uncertainty.
Support the Human Side of Emergencies
Obstetrical emergencies are emotionally intense. Fear, urgency, and uncertainty affect patients, families, and clinicians alike.
Strong teams:
- Designate someone to communicate clearly with the patient and family
- Recognize stress and cognitive overload among team members
- Debrief after the event to reflect and process the experience
Debriefing improves future performance and supports clinician well-being.
Build Systems That Support Teamwork
Even highly skilled teams struggle without supportive systems. Effective teamwork is reinforced by:
- Clear protocols for common obstetrical emergencies
- Rapid access to consultants, blood products, and operating rooms
- Physical spaces designed for team-based care
When systems are reliable, teams can focus on decision-making rather than logistics.
Conclusion
In an obstetrical emergency, no single clinician saves the day alone. Outcomes depend on how well a multidisciplinary team communicates, coordinates, and supports one another under pressure.
Real-world success comes from preparation, clarity, mutual respect, and shared purpose. In the emergency room, teamwork is not just a professional value. It is a critical clinical skill that saves lives.
Maternal 911 Education Systems, LLC is led by an experienced team that includes an obstetrician-gynecologist and a women’s health nurse practitioner specializing in emergency obstetrics as well as intrapartum and postpartum safety. Maternal 911 is dedicated to improving maternal outcomes through evidence-based education and interdisciplinary team training.
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Disclaimer: Educational use only — not a substitute for clinical judgment or local protocols.
