Making the "Birthing-Friendly" hospital designation better.

Area of Science:

• Maternal Health
• Healthcare Quality Improvement
• Health Services Research

Background:

• The Birthing-Friendly designation aims to identify high-quality maternity care hospitals.
• Widespread adoption of this designation raises questions about its effectiveness in reflecting true quality.

Purpose of the Study:

• To evaluate whether the Birthing-Friendly designation effectively differentiates hospitals based on meaningful quality measures.
• To assess the relationship between the designation and core maternal health metrics.

Main Methods:

• Analysis of hospital data comparing Birthing-Friendly designated hospitals with non-designated hospitals.
• Examination of metrics including early elective delivery rates and births-to-staff ratios.

Main Results:

• Birthing-Friendly hospitals are larger and implement quality improvement efforts.
• No consistent performance advantage was found for designated hospitals on core maternal health metrics.
• The designation may reflect capacity for quality improvement structures rather than consistent high-quality care.

Conclusions:

• The current Birthing-Friendly designation is not a reliable indicator of superior maternal care quality.
• A more comprehensive measure incorporating clinical outcomes, patient experience, and equity is needed.
• Particular attention should be paid to improving care for marginalized birthing populations.