Updated guidance from ACOG & SMFM to help hospitals provide risk appropriate maternal care

LoMC, first published in 2015, encourages the development of collaborative relationships between hospitals that offer different levels of maternal care in proximate regions. To that end, LoMC defines the required minimal capabilities, physical facilities, and medical and support personnel for each level of care, which include birth center, level I (basic care), level II (specialty care), level III (subspecialty care), and level IV (regional perinatal health care centers). Each subsequent level of care includes and builds on the capabilities of the lower levels.

●Accredited birth center: Care for low-risk women with uncomplicated singleton term vertex pregnancies who are expected to have an uncomplicated birth

●Level I (Basic care): Care of low to moderate risk pregnancies wit ability to detect, stabilize and initiate management of unanticipated maternal-fetal or neonatal problems that occur during the antepartum, intrapartum or postpartum period until the patient can be transferred to a facility at which specialty maternal care is available.

●Level II (Specialty Care): Level I facility plus care of appropriate moderate-to high-risk antepartum, intrapartum or postpartum conditions.

●Level III (Subspecialty Care):Level II facility plus care of more complex maternal medical conditions, obstetric complications and fetal conditions.