Bracelet Initiative

The Connecticut Urgent Maternal Warning Signs Bracelet Initiative — a state-funded effort led by the Connecticut Perinatal Quality Collaborative (CPQC) and the Connecticut Hospital Association (CHA) — aims to reduce maternal morbidity and mortality by improving clinical awareness of potential postpartum complications and conditions. Starting in the fall of 2025, birthing hospitals across the state are providing postpartum patients with an orange bracelet and an informational handout before leaving the hospital. The bracelet signals to healthcare professionals and first responders that the wearer is newly postpartum, enhancing timely recognition of and response to symptoms of potentially serious postpartum complications, known as “urgent maternal warning signs.” Complications may include eclampsia, blood clots, sepsis, cardiomyopathy, and perinatal depression. The Bracelet Initiative educates healthcare providers, including emergency department (ED) staff, and emergency medical services (EMS) personnel on standardized lifesaving protocols, ensuring postpartum patients seeking emergency services are identified and triaged appropriately. The initiative is funded through grants awarded to CHA by the Connecticut Departments of Public Health (DPH) and Children and Families (DCF).

Why Wear for 12 Weeks?

Orange bracelets are worn for a shorter period (12 weeks) because while serious complications can happen up to a year postpartum, the most critical, immediate life-threatening issues — like hemorrhage, blood clots, and eclampsia — often peak or present within the first few weeks to months, aligning with the recommended duration of wearing the bracelet to alert providers to ongoing risk after hospital discharge.

• The first 12 weeks — often called the “fourth trimester” — is a period of intense physical recovery when complications like postpartum preeclampsia, infection, or hemorrhage are most prevalent.
• While complications persist, the 12-week mark often coincides with the end of initial intensive postpartum care and the highest risk for the most immediate, severe crises.
• Some hospitals do encourage wearing the orange bracelet for up to a year, but the 12-week mark is a common standard for alerting providers to ongoing risk.

Blank Bracelets Rationale

Blank orange bracelets are available as an option to those who do not leave the hospital with a newborn due to situations such as a stillbirth, surrogacy, adoption, or loss of custody of a child at birth.

If you have any of these symptoms after pregnancy, contact your healthcare provider and get help right away. If you can’t reach your provider, go to an emergency department or call 911. This list is not meant to cover every symptom a patient might experience. If you feel like something just isn’t right, seek care.

Bracelet Initiative Background

In 2024, several Connecticut hospitals contemplating the creation of postpartum bracelet programs in their facilities requested that the Connecticut Perinatal Quality Collaborative (CPQC) scale the concept into a statewide initiative. CPQC participants supported the coalition pursuing the idea as a quality improvement (QI) project to complement the group’s ongoing efforts to address maternal morbidity and mortality in the postpartum period.

Hartford HealthCare and Trinity Health Of New England implemented bracelet programs in their respective health systems in the spring of 2025. The hospital leaders who built those programs collaborated with the CPQC and CHA to shape and execute the kickoff of the statewide Bracelet Initiative that fall. All initiatives are identical in purpose, design, and scope.

Initiative Rationale

According to the Connecticut Maternal Mortality Review Committee’s 2015-2020 Pregnancy-Related Deaths in Connecticut report, more than half of pregnancy-related deaths occur during the postpartum period, and most are considered preventable. This is consistent with national data. The Bracelet Initiative was designed to increase community awareness of preventable postpartum complications and conditions; ensure that birthing persons are empowered to seek help when experiencing symptoms of postpartum complications; and educate healthcare providers on potential complications during the postpartum period. Postpartum bracelet programs have produced positive results in other geographic areas. For example, East Carolina University Health Medical Center in North Carolina reduced postpartum readmissions from 2.24% in 2019 to 1.47% in 2022 after implementing postpartum bracelets. Other initiatives on urgent maternal warning signs have demonstrated improved timely ER recognition and triage of postpartum patients. For example, FHN Memorial Hospital in Illinois saw an increase in the percentage of postpartum patients moving from registration to triage in 10 minutes or less, from 38% to 61%.

Statewide Goals

GOAL 1: Increase awareness of urgent maternal warning signs among birthing persons and their family members.

Action Steps:

• Prior to discharge, birthing hospitals provide all postpartum patients with an orange bracelet and an informational handout detailing urgent maternal warning signs
• Healthcare providers encourage patients to wear the bracelet for 12 weeks postpartum
• Providers educate partners and other family members on urgent maternal warning signs

GOAL 2: Enhance the ability of healthcare providers, particularly those not specializing in maternal health, to recognize and respond to potential complications during the postpartum period.

Action Steps:

• In collaboration with hospitals, the CPQC trains healthcare providers and emergency services personnel on urgent maternal warning signs and treatment protocols
• In collaboration with hospitals, the CPQC develops and disseminates resources to reinforce the training
• In collaboration with hospitals, the CPQC offers ongoing training on related topics identified by healthcare providers

GOAL 3: Empower birthing persons to advocate for their health needs during the postpartum period.

Action Steps:

• Healthcare providers encourage patients to wear the bracelet for 12 weeks postpartum
• In collaboration with hospitals, the CPQC cultivates community partnerships on the state and local level
• In collaboration with hospitals, the CPQC and hospitals leverage a social media and digital advertising campaign to amplify the initiative’s reach and achieve maximum visibility