At a time when too many babies in the United States are delivered by c-sections that may not be necessary, and all too frequently labor is induced before a baby’s brain, lungs and other organs are fully developed, one of the nation’s leading women’s health organizations is praising the National Quality Forum (NQF) for adopting new perinatal consensus standards last week that hold the promise of improving the quality of care for women and newborns during the third trimester of pregnancy through hospital discharge.
The National Partnership for Women & Families is lauding the NQF for adopting the first set of maternal and newborn performance measures. Hospitals and freestanding birthing centers are now being asked to report their performance on 17 perinatal measures, including: how many elective deliveries the institution performs prior to 39 weeks gestation; how many newborns are exclusively breastfeeding and have received certain vaccinations at discharge; and the cesarean rate for low-risk women giving birth for the first time to one baby who is not breech. The new measures address care provided by nurses, doctors and midwives in both hospitals and free-standing birthing centers. Health plans, consumers and other providers will be able to review their performance and choose the institutions with the best record on patient safety in these areas.
“This is a major step forward in providing higher quality care to mothers and newborns,” said National Partnership President Debra L. Ness. “Pregnancy, childbirth and newborn care are the most common reasons for hospital admission, and childbirth-related procedures account for the five most common procedures in patients aged 18 to 44. As we improve the quality of care and reduce medical errors, we will give babies a healthier start and improve the health of their mothers, while at the same time using our health care resources more efficiently.”
“We are especially pleased that the new standards include a measure to report the rate of c-sections for women who are at low risk for complications and are delivering their first child,” Ness continued. “There is ample evidence that c-sections are being overused and needlessly putting women at risk. If widely used and publicly reported, these new measures can help support the solutions that organizations like Childbirth Connection recommended earlier this month to help us understand the causes of the soaring rate of c-sections. ”
“These new perinatal measures fill gaps in quality measurement and reflect important aspects of care that can be influenced by provider performance. With more than four million births per year in the United States, these measures will impact a large number of mothers and babies. Consumers will be especially interested in using this information to make informed decisions on choosing a provider and place of birth,” said Maureen Corry, Executive Director of Childbirth Connection, and Co-Chair of the NQF Perinatal Steering Committee.
“While this is a real advancement for women’s health, successful maternity outcomes do not turn only on the care received during the third trimester,” Ness cautioned. “They also depend on access to comprehensive, high quality reproductive health services as part of regular preventive and primary care. We need to continue the process of developing and endorsing measures that address the broader spectrum of reproductive health care.”
NQF is a voluntary consensus standards-setting organization. Ness is a National Quality Forum board member, and represents the National Partnership for Women & Families on the NQF Consumer Council, whose participants include more than 20 consumer advocacy organizations.
Ness also serves as a member on the National Priorities Partnership, an effort being led by NQF to identify national goals and priorities for improving the quality of health care. More information is available at http://www.qualityforum.org/.