2020 Vision for A High-Quality, High-Value Maternity Care System

Carter, Martha; Corry, Maureen P.; Delbanco, Suzanne; Foster, Tina; Friedland, Robert B.; Gabel, Robyn; Gipson, Teresa; Jolivet, R. Rima; Main, Elliott K.; Sakala, Carol; Simkin, Penny; Simpson, Kathleen Rice

doi:10.1016/j.whi.2009.11.006

Cited by 75 publications

(69 citation statements)

References 5 publications

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“…[15][16][17][18] This study confirms that pregnant women see multiple clinicians during the perinatal period. Because clinical circumstances may necessitate specialized care, and patients may shift among clinicians, care coordination is a clear need for pregnant women 19 and has been shown to improve outcomes, especially for underserved women. 20,21 One strategy that holds promise for improving care coordination is the patient-centered medical home model (PCMH) advocated by the American Academy of Family Physicians and other professional societies.…”

Section: Discussionmentioning

confidence: 99%

Care From Family Physicians Reported by Pregnant Women in the United States

Kozhimannil

Fontaine

2013

The Annals of Family Medicine

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PURPOSEWe describe the proportion of family physicians providing care of any sort to pregnant women in the United States from 2000 to 2009. METHODSWe used a repeat, cross-sectional design with data from the nationally representative Integrated Health Interview Series (2000Series ( -2009 for respondents who reported being pregnant at the time of the survey (N = 3,204). Using multivariate logistic regression, we modeled changes over time in pregnant women's reports of care from family physicians. We used interaction terms to test for regional differences in trends.RESULTS Approximately one-third of pregnant women reported having seen or talked to a family physician for medical care during the prior year, a percentage that remained stable for the period of 2000 to 2009 (adjusted odds ratio for annual change = 1.006). Most pregnant women reported care from multiple types of clinicians, including family physicians, obstetrician-gynecologists, midwives, nurse practitioners, and physician assistants. There were regional differences in trends in family physician care; pregnant women in the North Central United States increasingly reported care from family physicians, whereas women in the South reported a decline (6.7% annual increase vs 4.7% annual decrease, P ≥.001).CONCLUSIONS Trends in family medicine care for pregnant women have remained steady for the nation as a whole, but they differ by region of the United States. Most pregnant women reported care from multiple clinicians, highlighting the importance of care coordination for this patient population.

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Section: Discussionmentioning

confidence: 99%

Care From Family Physicians Reported by Pregnant Women in the United States

Kozhimannil

Fontaine

2013

The Annals of Family Medicine

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“…The health care delivery system promotes higher levels of care, fueling unwarranted procedures among healthy childbearing women 11. The vision for high‐quality, high value maternity care in the United States has been hampered by a lack of common definitions of risk in pregnancy 3, 7, 9, 11, 12, 13. In 2012, the Center for Medicare and Medicaid Innovation began Strong Start for Mothers and Newborns, a 4‐year initiative to test innovative models for improving childbirth outcomes for Medicaid beneficiaries.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of childbearing Medicaid beneficiaries engaged in care at Strong Start birth center sites between 2012 and 2014

Jolles

Langford

Stapleton³

et al. 2017

Birth

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BackgroundVariations in care for pregnant women have been reported to affect pregnancy outcomes.MethodsThis study examined data for all 3136 Medicaid beneficiaries enrolled at American Association of Birth Centers (AABC) Center for Medicare and Medicaid Innovation Strong Start sites who gave birth between 2012 and 2014. Using the AABC Perinatal Data Registry, descriptive statistics were used to evaluate socio‐behavioral and medical risks, and core perinatal quality outcomes. Next, the 2082 patients coded as low medical risk on admission in labor were analyzed for effective care and preference sensitive care variations. Finally, using binary logistic regression, the associations between selected care processes and cesarean delivery were explored.ResultsMedicaid beneficiaries enrolled at AABC sites had diverse socio‐behavioral and medical risk profiles and exceeded quality benchmarks for induction, episiotomy, cesarean, and breastfeeding. Among medically low‐risk women, the model demonstrated effective care variations including 82% attendance at prenatal education classes, 99% receiving midwifery‐led prenatal care, and 84% with midwifery‐ attended birth. Patient preferences were adhered to with 83% of women achieving birth at their preferred site of birth, and 95% of women using their preferred infant feeding method. Elective hospitalization in labor was associated with a 4‐times greater risk of cesarean birth among medically low‐risk childbearing Medicaid beneficiaries.ConclusionsThe birth center model demonstrates the capability to achieve the triple aims of improved population health, patient experience, and value.

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“…Using qualitative inquiry strategies, we sought key informants' views on existing prenatal care provision and on an innovative group care model (CenteringPregnancy R ) as a social health initiative. We argue that taking account of the locally specific context is critical to introducing maternity care interventions to improve the health of women and their families and to contribute to community development.Contradictory policy directions currently limit the reform of maternity care on policy agendas in the UK, Australia, and the United States (Carter, Corry, & Delbanco, 2010; Commonwealth of Australia, 2009; Department of Health [DH], 2007). On the one hand, the discourse of women's autonomy and empowerment has made its way from the women's health movement to mainstream discourse-professionals are now exhorted to provide "women-centered care" and "consumers" should be "consulted."…”

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confidence: 99%

Rethinking Prenatal Care Within a Social Model of Health: An Exploratory Study in Northern Ireland

McNeill

Reiger

2014

Health Care for Women International

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Implementation of maternity reform agendas remains limited by the dominance of a medical rather than social model of health. This article considers group prenatal care as a complex health intervention and explores its potential in the socially divided, postconflict communities of Northern Ireland. Using qualitative inquiry strategies, we sought key informants' views on existing prenatal care provision and on an innovative group care model (CenteringPregnancy®) as a social health initiative. We argue that taking account of the locally specific context is critical to introducing maternity care interventions to improve the health of women and their families and to contribute to community development.

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2020 Vision for A High-Quality, High-Value Maternity Care System

Cited by 75 publications

References 5 publications

Care From Family Physicians Reported by Pregnant Women in the United States

Care From Family Physicians Reported by Pregnant Women in the United States

Outcomes of childbearing Medicaid beneficiaries engaged in care at Strong Start birth center sites between 2012 and 2014

Rethinking Prenatal Care Within a Social Model of Health: An Exploratory Study in Northern Ireland

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