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The Transparency in Maternity Care Project was birthed in February of 2006 by the Grassroots Advocates Committee (GAC) of the Coalition for Improving Maternity Services (CIMS). We are a volunteer group dedicated to ensuring public access to quality of care information specifically related to maternity care providers and institutions. It is our intention to extend the current social trend toward transparency in health care into the virtually overlooked maternity care arena.
The Birth Survey is structured around the Coalition for Improving Maternity Services (CIMS) evidence-based 10 Steps to Mother-Friendly Care and other quality of care indicators. The creation of The Birth Survey has been inspired by Childbirth Connection's Listening to Mothers Survey (Harris Interactive, October 2002) and the A-CAHPS (Ambulatory Consumer Assessment of Healthcare Providers and Systems) program and surveys.
We believe that women of childbearing age must have access to information that will help them choose maternity care providers and institutions that are most compatible with their own philosophies and needs. We hope that the Transparency in Maternity Care Project will provide information that will help women make fully informed maternity care decisions.
We also believe that maternity care practitioners and institutions must have access to feedback from their patients. We hope that doctors, midwives, and hospital administrators will find the information generated through the Transparency in Maternity Care Project useful in quality improvement efforts.
Women need accurate, objective data in order to make fully informed choices about birth settings and providers. Practitioners and hospital administrators also need data to evaluate whether they are delivering quality care. We hope this project will fill a void by providing much needed information that benefits all parties engaged in maternity care.
Our goal is to give women a mechanism that can be used to share information about maternity care practices in their community while at the same time providing practitioners and institutions feedback for quality of care improvement efforts.
We are dedicated to improving maternity care for all women. We will do this by 1) creating a higher level of transparency in maternity care so that women will be better able to make informed decisions about where and with whom to birth and 2) providing practitioners and hospitals with information that will aid in evaluating and improving quality of care.
BRINGING TRANSPARENCY TO MATERNITY CARE
In the US, it is nearly impossible to access information about the quality of an individual health care provider or institution.The 2001 Institute of Medicine report, Crossing the Quality Chasm, underscores transparency as one of ten key steps necessary to overall health care system improvement. As national quality improvement initiatives continue to grow, maternity care must be included in this movement. The US spends more on maternity services than any other country in the world, yet we have the highest rates of infant death of all developed nations .1 The US also has one of the lowest vaginal birth rates in the world even though cesarean section carries greater risks to mother and baby. Despite emphasis on evidence-based medicine, cost-containment, and patient safety, the overuse of medical technology continues to rise without concomitant improvements in maternal or infant outcomes. Indeed, studies show that the inappropriate imposition of procedures, drugs, tests, and restrictions increase maternal and newborn morbidity and mortality. Although institutes, universities, and foundations are engaging in research or developing projects to increase health care transparency, currently, no significant consumer-led national effort is underway to share health care or maternity care information. A mechanism to share, systematically track, and retrieve up-to-date information about the quality of care received would equip consumers with the information necessary to make informed decisions and enable individuals to play a larger role in determining their care.