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Attaining Equitable High-Value Maternity Care

woman getting ultrasound while pregnant
  • The U.S. must do more to address the racial disparities and poor maternal health outcomes in the nation’s maternity care system

  • A culture of health equity that eliminates low-value services will be critical to achieving high-value maternity care

For many decades, the United States has failed people of color. Poor maternal health outcomes, troubling racial disparities, and the rising costs of maternity care present a call for action. To aid in this effort, the Health Care Transformation Task Force is launching new resources. The Maternal Health Hub houses a library of best practices; an accompanying report, Promoting Equity and Value in Maternity Care, explains the importance of treating equity as a central value, on par with quality and cost, in any delivery system reform.

Paying for value in health care means promoting care that produces better outcomes and better health. For care to be truly of high value it must be equitable, meaning it: is respectful; culturally competent providers are available; quality is consistent regardless of patient race, gender identity, or income; medical, behavioral, and social health are integrated; preferences are honored, and it does no harm. It is also important that the things that matter to patients are seen as important, as well as what is valued by providers and the health care system.

For an idea of what that would look like in practice, the Health Care Transformation Task Force surveyed 22 maternal health experts and stakeholders including patient advocates, providers, payers, purchasers, government, researchers, professional and trade associations, asking: “What maternity services and care models do you consider high-value, and which maternity services and care models do you consider low-value?” Their answers reflected below are a strong start to a conversation about what value really means in maternity care.

Naming and addressing systemic racism, classism, and sexism in health care — rather than addressing race as a risk factor — is a critical step toward eliminating health disparities and creating a system that recognizes and honors preferences. Providers, payers, patient organizations, and other stakeholders can consider the best practice interventions and improvement strategies highlighted in the report and share their successes and setbacks widely. To join the conversation, visit

Publication Details



Clare Pierce-Wrobel, Katie Green, and Laurie Zephyrin, "Attaining Equitable High-Value Maternity Care," To the Point (blog), Commonwealth Fund, June 30, 2020.