Measuring the Quality of Obstetric Care During Childbirth

Increasingly comprehensive maternal morbidity and mortality data in the United States has revealed stagnating or worsening rates of poor maternal outcomes during childbirth, including stark disparities based on maternal race and ethnicity. This prompts a call to action to improve obstetric care across the nation and review clinical indicators that have been proposed to measure the quality of care during childbirth. This systematic review of the literature examines both published and unpublished literature from both domestic and international sources to compile a comprehensive list of proposed clinical quality indicators for obstetric care. The indicators are then categorized by clinical area, and descriptive characteristics of indicators are presented. A discussion of the indicators centers on the advantages and disadvantages of specific indicator characteristics, as well as the variations in indicator characteristics based on the indicator source. The book concludes with implications and recommendations for clinicians and policymakers, and outlines opportunities for further research.