ACOG/SMFM Propose a New Classification System for US Maternity Care Facilities

January 22, 2015 – American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine issued a consensus document proposing a classification system for levels of maternal care in the US. This document is the second in the ACOG/SMFM Obstetric Care Consensus Series and was designed to reduce maternal mortality.

The document, ACOG/SMFM Obstetric Care Consensus Series – Levels of Maternal Care, introduces a five level classification system based on a facility’s ability to handle various levels of maternal care. Maternal care is defined as referring to all aspects of antepartum, intrapartum, and postpartum care of the pregnant woman. The proposed classification system levels are:

1. birth centers
2. basic care (level I)
3. specialty care (level II)
4. subspecialty care (level III)
5. regional perinatal health care centers (level IV)

The goal of regionalized maternal care is for pregnant women at high risk to receive care in facilities that are prepared to provide the required level of specialized care, thereby reducing maternal morbidity and mortality in the United States.

The document promotes collaborative care between maternity care professionals including CNMs, CMs, CPMs, and licensed midwives working at birth centers but specifically excludes home birth.