Childbirth Connection releases two landmark reports focusing maternity care in the U.S.

Childbirth Connection today released two landmark reports that create a framework for revamping maternity care in the U.S. and advancing health care reform: "2020 Vision for a High Quality, High Value Maternity Care System" and "Blueprint for Action." The reports were developed through an extensive multi-year collaboration with more than 100 maternity care leaders representing industry stakeholders -- from hospitals and health plans to consumers and providers. These reports and related papers have just been published in a special supplement of Women's Health Issues.

"Recognizing that rapid gains in the quality, value and outcomes of maternity care are well within reach, Childbirth Connection launched its Transforming Maternity Care project several years ago," said Maureen Corry, executive director, Childbirth Connection. Although a wealth of high-quality evidence and experiences of high-performing segments of the maternity care system were readily available to improve maternity care, these resources were not impacting most women and newborns. "It was time to act and we called upon key leaders across the health care system to develop a long-term vision for the future of maternity care in the United States. This vision served as a starting point for a collaborative process to develop action steps for broad-based maternity care system improvement," said Corry.

Maternity care is the runaway leader in hospital charges and is the number one reason for hospitalization in the country. Maternal and newborn hospital charges alone exceeded $86 billion in 2007, with employers and private insurers paying for 50% of all births and Medicaid paying for 42%. While most childbearing women and their babies are healthy and at low risk, the current style of maternity care is technology-intensive. Costly childbirth procedures that entail risk are overused and wasteful, while proven ones that are generally safer and less expensive are underutilized. Marked disparities in access, quality and outcomes persist, with many maternal and newborn health indicators moving in the wrong direction. The return on investment for our significant expenditure in this important sector is poor.

"The good news is that every challenge is an opportunity for improvement that can benefit millions of mothers and babies annually. The '2020 Vision' developed by a multi-disciplinary, multi-stakeholder team, puts forth the values, principles and attributes of an optimal maternity care system and describes fundamental goals for a system meeting those criteria," said Rima Jolivet, Transforming Maternity Care Project Director, Childbirth Connection. "With the '2020 Vision' in hand, five stakeholder workgroups collaborated to develop reports with recommendations and action steps for moving toward the vision," said Jolivet.

Stakeholder workgroup chairs presented their reports and recommendations at an invitational policy symposium commemorating Childbirth Connection's 90th anniversary. Transforming Maternity Care: A High Value Proposition was held at Georgetown University, Washington DC, in April 2009. Invited discussants, moderators and the audience provided comments to strengthen the reports and recommendations. The Transforming Maternity Care Steering Committee then synthesized the workgroup reports and additional feedback into the direction-setting report, "Blueprint for Action: Steps Toward a High-Quality, High-Value Maternity Care System." The Blueprint answers the question "Who needs to do what, to, with and for whom to improve the quality of maternity care over the next five years?" Actionable strategies to improve maternity care quality and value are centered on eleven critical focus areas for change:

-- Performance measurement and leveraging of results -- Payment reform to align incentives with quality -- Disparities in access and outcomes of maternity care -- Improved functioning of the liability system -- Scope of covered maternity care services -- Coordination of care across time, settings and disciplines -- Clinical controversies -- Decision-making and consumer choice -- Scope, content and availability of health professions education -- Workforce composition and distribution -- Development and use of health information technology

"A great achievement of the project is the remarkable level of consensus that was reached by the workgroups through an in-depth, collaborative process to arrive at negotiated agreements and sound proposals for tackling complex issues," said Ned Calonge, Chief Medical Officer, Colorado Department of Public Health and Environment, who served as Chair of the workgroup for Maternity Care Clinicians and Health Professions Educators.

The Blueprint for Action is the first step in a long-term initiative to undertake collaborative national, regional, and local endeavors to improve maternity care quality and value. At the briefing, Corry announced the establishment of a public-private Transforming Maternity Care Partnership to carry out the next phase of the project and implement Blueprint steps to accelerate health system change.

"We welcome all maternity care stakeholders to identify relevant Blueprint steps and join this effort to attain rapid achievable gains in maternity care quality and value on behalf of childbearing women and newborns," said Donna Lynne, President of Kaiser Permanente Health Plan of Colorado and Transforming Maternity Care Steering Committee member.