This report summarizes the best available research about the impact of the health care liability system on maternity care, and policy strategies for improved functioning of the liability system in maternity care. Improved understanding of these matters can help transcend polarized discourse, guide policy intervention, and address persistent shortcomings.
The liability system is not serving well childbearing women and families and providers and payers of maternity care services. The report identifies seven aims for a high-performing liability system in this clinical context. It holds 25 improvement strategies that have been proposed and/or implemented up to these criteria and finds that 15 strategies have not been found to be effective in addressing needs of diverse stakeholders and/or are unlikely to do so. Ten strategies appear to have promise to improve liability matters across multiple aims. These health care, tort alternative, and liability insurance reforms are stronger candidates for demonstration, evaluation, and refinement to prevent injury or assist women, babies, and families when it occurs. They also hold promise for reducing liability-associated stressors of health professionals and improving the value of maternity care to payers. An appendix summarizes many important gaps in knowledge relating to maternity care and liability, and another provides summary fact sheets on key questions of interest to diverse stakeholders.
Download: Maternity Care and Liability: Pressing Problems, Substantive Solutions (full report)
Download: Fact Sheets: Maternity Care and Liability Findings on Topics of Interest to Policy Makers and Others (set of 10 fact sheets)
Download Individual Fact Sheets:
- Policy Framework for Improving the Liability Environment for Women and Newborns, Maternity Care Providers, and Payers
- Affordability of Liability Insurance Premiums to Maternity Care Providers
- Occurrence of Negligent Injury and of Claims and Payouts in Maternity Care
- Defensive Practice in Maternity Care
- Liability-Associated Distress Among Maternity Care Providers: Sources and Solutions
- Impact of Caps on Non-Economic Damages and Other Tort Reforms in Maternity Care
- Interventions that are Unlikely to Foster Substantive Liability Solutions in Maternity Care
- Substantive Solutions for Preventing and Responding to Injury in Maternity Care
- Impact of Maternity Care Quality Improvement Programs on Liability
- Maternity Care and Liability: Gaps in Knowledge
Download: Media Release: Maternity Care and Liability: Many Solutions Could Alleviate Persistent Problems
Simultaneous with publication of the full report, the journal Women’s Health Issues has published 3 related peer-reviewed articles and an invited commentary by legal scholars Sara Rosenbaum, JD, and William Sage, MD, JD. These resources are available freely from Women’s Health Issues.
- A Policy Matters Focus on Maternity Care and Liability, by Carol Sakala, PhD, MSPH
- Maternity Care and Liability: Pressing Problems, Substantive Solutions, by Carol Sakala, PhD, MSPH, Y. Tony Yang, ScD, LLM, MPH, and Maureen P. Corry, MPH
- Maternity Care and Liability: Most Promising Policy Strategies for Improvement, by Carol Sakala, PhD, MSPH, Y. Tony Yang, ScD, LLM, MPH, and Maureen P. Corry, MPH
- Maternity Care and Liability: Least Promising Policy Strategies for Improvement, by Carol Sakala, PhD, MSPH, Y. Tony Yang, ScD, LLM, MPH, and Maureen P. Corry, MPH
- Commentary: Maternity Care and Liability, by Sara Rosenblum, JD, and William Sage, MD, JD