Maternity Care and Liability: Pressing Problems, Substantive Solutions summarizes the best available research about the impact of the health care liability system on maternity care, and policy strategies for improved functioning of the liability system in maternity care. Improved understanding of these matters can help transcend polarized discourse, guide policy intervention, and address persistent shortcomings.

The liability system is not serving well childbearing women and families and providers and payers of maternity care services. The report identifies seven aims for a high-performing liability system in this clinical context. It holds 25 improvement strategies that have been proposed and/or implemented up to these criteria and finds that 15 strategies have not been found to be effective in addressing needs of diverse stakeholders and/or are unlikely to do so. Ten strategies appear to have promise to improve liability matters across multiple aims. These health care, tort alternative, and liability insurance reforms are stronger candidates for demonstration, evaluation, and refinement to prevent injury or assist women, babies, and families when it occurs. They also hold promise for reducing liability-associated stressors of health professionals and improving the value of maternity care to payers. An appendix summarizes many important gaps in knowledge relating to maternity care and liability, and another provides summary fact sheets on key questions of interest to diverse stakeholders.

Report and Findings

• Maternity Care and Liability: Pressing Problems, Substantive Solutions
• Maternity Care Quality Improvement Strategies with Potential to Reduce Liability (table)

Fact Sheets

• Policy Framework for Improving the Liability Environment for Women and Newborns, Maternity Care Providers, and Payers
• Affordability of Liability Insurance Premiums to Maternity Care Providers
• Occurrence of Negligent Injury and of Claims and Payouts in Maternity Care
• Defensive Practice in Maternity Care
• Liability-Associated Distress Among Maternity Care Providers: Sources and Solutions
• Impact of Caps on Non-Economic Damages and Other Tort Reforms in Maternity Care
• Interventions that are Unlikely to Foster Substantive Liability Solutions in Maternity Care
• Substantive Solutions for Preventing and Responding to Injury in Maternity Care
• Impact of Maternity Care Quality Improvement Programs on Liability
• Maternity Care and Liability: Gaps in Knowledge
• Bundle of all 10 fact sheets

Journal Articles

• A Policy Matters Focus on Maternity Care and Liability, Carol Sakala, PhD, MSPH
• Maternity Care and Liability: Pressing Problems, Substantive Solutions, Carol Sakala, PhD, MSPH, Y. Tony Yang, ScD, LLM, MPH, and Maureen P. Corry, MPH
• Maternity Care and Liability: Most Promising Policy Strategies for Improvement, Carol Sakala, PhD, MSPH, Y. Tony Yang, ScD, LLM, MPH, and Maureen P. Corry, MPH
• Maternity Care and Liability: Least Promising Policy Strategies for Improvement, Carol Sakala, PhD, MSPH, Y. Tony Yang, ScD, LLM, MPH, and Maureen P. Corry, MPH
• Commentary: Maternity Care and Liability, Sara Rosenblum, JD, and William Sage, MD, JD