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WASHINGTON (December 4, 2008)—Information on policies, protocols and rates of outcomes in the United States maternity care system—known as “transparency”—is widely unavailable to the general public. Without this information, women cannot make fully informed decisions about their health care, which can have adverse effects on their care during pregnancy and birth, according to Elan McAllister in her article published in The Journal of Perinatal Education. As a result, several grassroots projects have developed to address this need.

Transparency in maternity care serves two primary functions: to allow women and their families to make informed choices relevant to their care in pregnancy and birth; and to hold medical facilities and practitioners more accountable for their policies and practices. Transparency requires medical facilities to disclose accurate rates of birth outcomes, commonly used medical procedures, and cesarean surgeries. Transparency also requires practitioners to provide rates of procedures used (including episiotomies and cesareans) as well as patient satisfaction reports. The belief is that when practitioners and facilities are held more accountable, the quality of care improves.

Without transparency, a woman is unable to make informed decisions regarding her care. According to McAllister, where and with whom a woman births directly affects her experience and chance of enduring certain obstetrical interventions, including induction, episiotomy and cesarean surgery, all of which carry risks. Women who choose a facility or practitioner with a high rate of cesarean surgery, for example, increase their risk of having a cesarean birth.

“Choosing the right facility and practitioner is one of the most important first steps toward a healthy pregnancy and birth,” says Lamaze International President Pam Spry, PhD, CNM, FACNM, LCCE. “The medical system is responsible to provide women with the ability to make an informed choice.”

In an effort to increase the level of transparency, several non-profit organizations and government agencies have called upon the health care system to fully disclose information related to a patient’s health care decisions. Choices in Childbirth (CIC), a non-profit organization in New York City, helped to enforce New York State’s Maternity Information Act. The act requires every hospital and birth center to provide a pamphlet for the public that contains definitions of obstetric procedures and their annual rates of performance. CIC is working to help activists in other states pass similar legislation.

The Birth Survey is another significant initiative in transparency. The Birth Survey, an online consumer survey founded by the Coalition for Improving Maternity Services, asks women to provide feedback on their birth experience in relation to their practitioner and birthing facility. Responses from the survey are available online to help other women decide where and with whom in their community to birth. Women who have birthed in the last three years are encouraged to take the survey and review the results at www.thebirthsurvey.com.


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About The Journal of Perinatal Education
The Journal of Perinatal Education is the leading peer-reviewed journal for childbirth educators. The Journal is published quarterly by Lamaze International for readers who provide parent education in the areas of childbirth, pregnancy, breastfeeding, neonatal care, postpartum, early parenting and young family development. For more information about The Journal of Perinatal Education and Lamaze International, visit www.lamaze.org.  

About Lamaze International
Since its founding in 1960, Lamaze International has worked to promote, support and protect normal birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area networks, its members and volunteer leaders include childbirth educators, nurses, midwives, doulas, lactation consultants, physicians, students and consumers. For more information about Lamaze International and the Lamaze Institute for Normal Birth, visit www.lamaze.org.

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