• Too many healthy pregnant women experience unnecessary surgery and other interventions – while 1 in 3 childbearing women gave birth by cesarean section in 2007, many cesareans could have been avoided if maternity quality were truly a priority.
• Recent reports indicate that some health insurance companies are rejecting coverage for women with a history of cesarean surgery, and other companies are charging cesarean mothers significantly higher premiums to get the same coverage as women without a previous cesarean (New York Times, 6/1/08). 
• America's preterm and low birth weight rates have been rising for decades, and planned cesareans in low-risk women are contributing to the increase.
• Practice variation among providers, facilities and geographic areas points to the need for quality improvement. For example, in 2006 cesarean section rates in New York State hospitals ranged from 17% to 50%, while vaginal birth after cesarean (VBAC) rates ranged from 0% to 36%. Furthermore 71% of hospitals no longer offer VBAC, an option recommended by the American College of Obstetricians and Gynecologists.
• Troubling ethnic and racial disparities in maternity care involve differences in choice, control, and the way care is provided, resulting in unacceptable and for many indicators widening gaps in outcomes.
• Overall, U.S. maternity care does not measure up to the Institute of Medicine's six aims for quality improvement: to make care safe, effective, patient-centered, timely, efficient and equitable.

• Building awareness among members of Congress of the need to improve quality maternity care. In a 2007 briefing sponsored by the bipartisan Congressional Women's Caucus, our presentation focused on why mothers and babies warrant focused policy attention, cost implications of the gap between evidence and current practice, and strategies for closing the gap.
• Completing a new report to be issued by Milbank Memorial Fund and Reforming States Group on the impact of the liability system on maternity care and leading policy options for improving the situation.
• Holding a national policy symposium – Transforming Maternity Care: A High Value Proposition – on April 3, 2009. Our framework is in place and we've already engaged close to 100 national quality improvement leaders in working to assess the current maternity care system, clarify optimal maternity care, and identify effective strategies for improving quality, access and value. Timed to coincide with changes in leadership at the federal and state levels, the symposium project will create a blueprint for action and build partnerships for implementing the blueprint.
• Continuing to conduct national surveys of childbearing women to better understand their experiences and perspectives and parlay this knowledge to improve maternity policy, practice, education and research.
• Furthering our relationship with key national organizations dedicated to improving health care quality like the National Quality Forum, the Consumer-Purchaser Disclosure Project, and Consumers United for Evidence-based Healthcare, giving us a greater voice in advocating for the needs and interests of childbearing families.

Through Maternity Quality Matters and your support, Childbirth Connection will take advantage of unprecedented opportunities for impact and change. Please give as generously as you can today. If mothers and babies matter to you, Maternity Quality Matters…and so does your support. Thank you very much.