Editorial Views  |   August 2019
Measuring What Matters to Moms Most
Author Notes
  • From the Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas (J.M.M.); and the Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts (B.T.B.).
  • This editorial accompanies the article on p. 238 and has a related Infographic on p. 15A.
    This editorial accompanies the article on p. 238 and has a related Infographic on p. 15A.×
  • Accepted for publication April 12, 2019.
    Accepted for publication April 12, 2019.×
  • Address correspondence to Dr. Bateman: bbateman@bwh.harvard.edu
Article Information
Editorial / Obstetric Anesthesia / Pediatric Anesthesia / Quality Improvement
Editorial Views   |   August 2019
Measuring What Matters to Moms Most
Anesthesiology 8 2019, Vol.131, 223-225. doi:https://doi.org/10.1097/ALN.0000000000002794
Anesthesiology 8 2019, Vol.131, 223-225. doi:https://doi.org/10.1097/ALN.0000000000002794
The safety of maternity care in the United States has lagged behind that of other countries and continues to generate a dismal record of maternal and perinatal morbidity and mortality.1  Investigative reporters recently identified 120 hospitals in the United States where birth complications exceed the national average by more than two-fold.2  The public, long aware of perinatal harm and unnecessary cesarean delivery, is increasingly focused on the attendant risks of maternal morbidity and mortality, and childbirth advocates now demand accountability from the U.S. health system.
Existing quality measures in obstetrics fail to fully capture safe maternal care and optimal neonatal outcomes. The Joint Commission perinatal care measures focus on elective delivery before 39 weeks gestational age, low-risk cesarean delivery, antenatal steroids, health care–associated bloodstream infections in newborns, and exclusive breastfeeding.3  None are risk-adjusted, and all are easily dismissed in underperforming hospitals, where poor measurement performance is frequently blamed on the patient population served.2  The public is skeptical, and now reporters are interviewing women who have suffered irreparable harm and families of those who have died to reveal the extent to which the adverse outcomes reflect failures in clinical care.2,4