Description

Issue: To improve maternal and birth outcomes, the North Carolina General Assembly passed North Carolina Session Law 2018-93. Additionally, the North Carolina Division of Public Health, developed North Carolina’s Perinatal Health Strategic Plan 2016-2020. Goal 3 of the plan is to “improve the quality of maternal care.” One of the strategies for this goal is to “ensure that pregnant women and high-risk infants have access to the appropriate level of care through a well-established regional perinatal system.” This NCIOM Task Force, in partnership with the Women’s and Children’s Health Section, Division of Public Health, NC Department of Health and Human Services convened to respond to Session Law 2018-93 and develop a perinatal system of care for the state.

North Carolina Session Law 2018-93:

• Study:
  1. The complexity levels of care currently being provided by all delivering hospitals in caring for birth mothers and newborns.
  2. How current systems of referral and transport to different facilities and specialty providers based on patient risk are being managed.
  3. Disparities in access to risk-appropriate maternal and hospital care.
  4. Service gaps.
  5. Issues that impact the ability to most appropriately match patient need with provider skill.
  6. Recommendations for actionable steps that can be taken in North Carolina to best ensure that pregnant women receive quality prenatal care and that mothers and newborns are cared for in a facility that can meet their specific clinical needs.
  7. Any other issues the Department deems relevant to this study.

NC Perinatal State Health Plan:

• Goal 3E: Ensure that pregnant women and high-risk infants have access to the risk appropriate level of care through a well-established regional perinatal system.
  • Decrease the percent of Very Low Birthweight (VLBW) and high-risk babies who are born at Level 1 and Level 2 hospitals 2.
  • Define, identify and promote centers of excellence for VBAC (vaginal birth after cesarean).
  • Assess the levels of neonatal and maternity care services for hospitals using the consensus recommendations of the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), and the Society for Maternal-Fetal Medicine (SMFM)
    • North Carolina’s current criteria for assessing the levels of neonatal and maternity care services for hospitals are outdated and do not reflect current best practices.

Spotlight Series:

Each month, we highlight a unique perspective from North Carolinian’s personally impacted by the current perinatal system of care. Check out this month’s spotlight on doulas