title: Maternity care and liability: pressing problems, substantive solutions.
abstract: BACKGROUND
  This paper summarizes a new report presenting the best available research about the impact of the liability environment on maternity care, and policy options for improving this environment. Improved understanding of these matters can help to transcend polarized discourse and guide policy intervention.
  
  
  METHODS
  We used a best available evidence approach and drew on more recent empirical legal studies and health services research about maternity care and liability when available, and considered other studies when unavailable.
  
  
  RESULTS
  The best available research does not support a series of widely held beliefs about maternity care and liability, including the economic impact of liability insurance premiums on maternity care clinicians, the existence of extensive defensive maternity care practice, and the impact of limiting the size of awards for non-economic damages in a malpractice lawsuit. In the practice of an average maternity caregiver, negligent injury of mothers and newborns seems to occur more frequently than any claim and far more frequently than a payout or trial. Many important gaps in knowledge relating to maternity care and liability remain. Some improvement strategies are likely to be more effective than others.
  
  
  CONCLUSIONS
  Empirical research does not support many widely held beliefs about maternity care and liability. The liability system does not currently serve well childbearing women and newborns, maternity care clinicians, or those who pay for maternity care. A number of promising strategies might lead to a higher functioning liability system, whereas others are unlikely to contribute to needed improvements.
authors: Childbirth Connection, New York, New York 10016, USA. sakala@childbirthconnection.org
authors: Carol
authors: C
authors: Sakala
authors: Y Tony
authors: YT
authors: Yang
authors: Maureen P
authors: MP
authors: Corry
mesh_terms: D003675:Defensive Medicine / Q000458:organization & administration; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D007231:Infant, Newborn; D007351:Insurance, Liability / Q000191:economics / Q000331:legislation & jurisprudence*; D016365:Liability, Legal / Q000191:economics*; D008318:Malpractice / Q000191:economics* / Q000331:legislation & jurisprudence; D008427:Maternal Health Services / Q000458:organization & administration; D009774:Obstetrics / Q000191:economics / Q000331:legislation & jurisprudence*; D011050:Policy Making; D017749:Total Quality Management; D014481:United States