In 2025, the landscape of maternal healthcare in the United States faces unprecedented pressure. Rising costs, stark disparities, workforce shortages, and the ever-increasing complexity of patient needs have forced leaders to rethink not just how care is delivered—but why. The challenges are familiar: the U.S. remains one of the most expensive countries in which to give birth, and persistent gaps in outcomes across race, income, and geography have become national priorities. But a new wave of leadership—nurses-turned-executives, strategic consultants, and interdisciplinary teams—are driving change from the frontlines to the boardroom.
In a recent episode of the American Journal of Healthcare Strategy Podcast, I spoke with Cassandra Stompoly, MSN, Senior Advisor at Modality Global Advisors, who draws on 24 years of experience in labor and delivery nursing and women’s health leadership. Cassandra shared how bedside insights, business acumen, and a relentless focus on communication are redefining both patient experience and organizational performance. This conversation delivers practical answers, inspiring leadership lessons, and a roadmap for implementing change—no matter where you sit in the health system.
The core question: What compels a seasoned labor and delivery nurse to step into leadership and consulting?
Cassandra’s answer is rooted in experience: “As a bedside labor and delivery nurse, there were all kinds of times where people would come to me as a natural leader on the floor… and want me to kind of step forward to bring those issues to upper management.” Ultimately, leadership wasn’t just an ambition, but a necessity—born from repeatedly advocating for patients and colleagues and recognizing the limits of influence at the bedside.
Her turning point was as personal as it was professional. “I would come home from the hospital working my shifts and say, ‘This is what’s going on,’ to my husband. Finally, he said, ‘It’s time to put up or shut up—you can either go back and get your master’s and try to make a difference, or continue to do what you’re doing at the bedside.’” Juggling a career and four children, Cassandra pursued advanced education, earning both a psychology degree and a master’s in nursing, then stepping into management and ultimately, consulting.
Leadership can—and should—emerge at every level.
Formal education often opens doors, but it’s the drive to solve real problems that sustains a career.
Transitions are hard but necessary for those who want to change the system from within.
The core question: What issues keep maternal health leaders up at night, and where are the greatest opportunities for impact?
Cassandra is frank: “There’s a lot to unpack… We can start with disparities: socioeconomic, racial, cultural—all factor into maternal outcomes.” She highlights two persistent issues:
High Cost of Childbirth: U.S. childbirth costs are among the highest in the world, straining families and healthcare systems alike.
Disparities in Outcomes: Outcomes differ dramatically based on race, income, geography, and access to care.
But there’s more. Cassandra adds: “One of the main focuses now is surrounding depression and postpartum depression… How do we address those kinds of issues within the pregnant and postpartum patient?”
Implicit Bias: “The biggest thing—the first step—is recognizing that there are implicit biases… You don’t mean to have them, they’re just there. So, recognizing differences—cultural, language, socioeconomic—is critical.”
Access and Language: Hospitals must provide interpreter services and tailored patient education.
Mental Health: Screening for postpartum depression is moving upstream (prenatally, at delivery, and postpartum)—but often, pediatricians are the first to notice symptoms.
Holistic, Family-Centered Care: Patient, baby, and family all need to be part of the care plan.
The core question: What does it take to operationalize equity and mental health initiatives?
Action starts with recognition, then moves to communication and system change. Cassandra explains: “Many hospitals are moving toward annual competencies in these different biases… not just for the med-surg patient, but specifically in labor and delivery.”
For postpartum depression:
Screening now happens at multiple points: prenatal visits, delivery, and postpartum checkups.
Pediatricians are often the “canary in the coal mine,” noticing red flags during well-baby visits and helping direct mothers to resources.
Open Communication: “There’s no shame in having postpartum depression… We need to make sure we’re opening the lines of communication so we can address those and take care of our patients holistically.”
Annual Training: On implicit bias, cultural competence, and trauma-informed care.
Integrated Screenings: Use standardized tools for mental health at every stage of perinatal care.
Interdisciplinary Teams: Include OB/GYNs, pediatricians, nurses, social workers, and mental health professionals.
Learning from Peers: “You don’t need to reinvent the wheel. Reach out to local or sister hospitals—ask what’s working and how you can adapt it.”
The core question: Which technological advances are most impactful for maternal care, especially post-pandemic?
Cassandra is clear: “Everything changed with COVID… The way we deliver healthcare, the technology we use, all became so much more important.” She emphasizes two main innovations:
Expands Access: “We’re using technology to reach remote places… Most people have a cell phone or a computer, so using that technology for visits is huge.”
Reduces Barriers: Telehealth bridges gaps for rural patients, working mothers, and those with limited mobility.
Continuous Monitoring: For high-risk pregnancies (hypertension, gestational diabetes), real-time monitoring and centralized call centers allow immediate intervention.
“Nowadays, patients can walk around the room, sit on a birthing ball, walk the halls—all while being wirelessly monitored. We’re not losing data, but we’re also not creating barriers to the patient experience they want to have.”
Provider Collaboration: Integrated EHRs allow all specialists to see up-to-date information without burdening patients with paperwork.
Patient-Centric: Simplifies care coordination, especially for high-risk or multi-provider cases.
Elevated Patient Experience: Less time tethered to machines, more mobility, and personalized care plans.
Improved Outcomes: Early identification of complications, rapid escalation, and reduced unnecessary transfers—especially for rural hospitals.
The core question: How should resource-limited organizations prioritize investments in maternal health?
Cassandra doesn’t sugarcoat it: “Everything comes down to that bottom line, and hospitals after COVID have struggled… They’re doing more with less.” For rural or under-resourced hospitals, it’s a balancing act.
Patient Safety Above All: “Safe, evidence-based practice care has to be the priority.”
Technology Triage: Invest first in telehealth and EHR integration before moving to high-cost wireless monitoring or other advanced tools.
Budget-Conscious Decisions: “You can continue to fetal monitor without wireless. Update your EHR before buying the latest equipment.”
Expand Catchment, Not Costs: Telemedicine “gives you a bigger net… A small hospital can service a whole county, reducing the need for mothers to drive hours for a 30-minute appointment.”
Transportation: Virtual visits reduce the burden for mothers balancing jobs, childcare, and long travel times.
Workforce: Less stress means higher satisfaction for both patients and staff.
Outcomes: Cassandra notes, “We’re seeing healthier pregnancies, fewer transports out, and more mom-baby pairs kept together in their home hospital.”
The core question: How can leaders stay agile in the face of changing government and payer policies?
Cassandra’s approach is rooted in transparency and collaboration: “I work very closely with Revenue Integrity, Finance, and providers… We have open discussions about what we’re seeing and how we can marry that with the care we’re giving.”
Every State Is Different: “Every state has a little bit of different stuff… You have to move and adjust—that’s probably the biggest struggle.”
Insurance Nuances: Length of stay, bundled payments, and reimbursement models vary widely; knowing the details is essential.
Safe Discharges, Not Early Discharges: “Since COVID, most of our postpartum patients are going home at the 24-hour mark… But it has to be a safe discharge, not just a quick one.”
Understand Your Local Environment: Dive deep into state-specific laws, scope of practice, and standard of care.
Open the Conversation: “Communication and transparency are really key—I want my staff to understand hospitals are a business, but patient safety has to be the bottom line.”
Learn from All Sides: Cassandra credits her unique insight to “conversations with my husband, who is an insurance attorney… That helps me see the nuances from both care and payer perspectives.”
The core question: What’s the secret to effective, resilient leadership in women’s and children’s health services?
Cassandra emphasizes humility, inclusivity, and relentless transparency: “It’s not always my idea… The more heads that are thinking about a certain project or policy, the better. You have different specialties that come together to address all aspects.”
Foster Communication: Open channels across all roles—from bedside to boardroom.
Embrace Iteration: “There’s nothing wrong with saying, ‘That was my idea, it didn’t work—let’s try that again.’”
Prioritize Patient Safety and Experience Together: These are not competing goals, but mutually reinforcing.
Model Transparency: Admit mistakes, share successes, and continually adjust strategy in real time.
The future of maternal and fetal health depends on leaders who can translate bedside wisdom into boardroom strategy, who embrace both technology and teamwork, and who never lose sight of the patient’s experience. Cassandra Stompoly, MSN, shows us that the foundation of every breakthrough—whether clinical, operational, or policy-related—is communication. As she put it, “If you’re opening communication across the board and everyone has the same focus on safe patient care and the best patient experience, it drives patient safety—and organizational performance.”
Actionable Insight:
Whether you’re a frontline nurse, C-suite executive, or consultant, ask yourself: How are you building bridges across disciplines, learning from others, and relentlessly advocating for what’s best for women and families? Start by opening a conversation—then keep it going.
