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Delivering Confidence Across All Levels of Maternal Care

While health care has made significant advances in obstetrics and maternal-fetal care, there is still more to be done to standardize, implement, and improve regionalized systems of care. Maternal Levels of Care Verification, now available, delivers a way to bridge that gap and improve patient outcomes.

Collaborating with the American College of Obstetricians and Gynecologists (ACOG), Joint Commission offers a program to facilities that provide obstetric and maternal-fetal medicine (MFM) care. The program was developed using ACOG’s Levels of Maternal Care Obstetric Care Consensus (OCC) document, which includes comprehensive uniform definitions, a standardized description of maternity facility capabilities and personnel, and a framework for integrated systems that address maternal health needs. The program aims to reduce maternal morbidity and mortality by encouraging the growth and evolution of systems that help standardize perinatal regionalization and risk-appropriate maternal care.

Several states have passed legislation to establish levels of maternal care designations for all hospitals that provide maternity care and more states are expected to do the same.

Get ahead of the game and achieve Maternal Levels of Care Verification.

Level of Care Assessment by The Joint Commission

Through the Maternal Levels of Care Verification program, Joint Commission experts provide an objective assessment of a facility's capabilities. By verifying that a hospital treats patients it has the expertise, equipment, and resources to care for, Maternal Levels of Care Verification facilitates more safe, successful births and maternal outcomes. With verification, a facility can strengthen the community’s confidence in the quality and safety of its services and treatments.

Four Levels of Care Assessed

  • Level I: Basic Care – Care for low to moderate-risk pregnancies, demonstrating the 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 the specialty maternal care is available
  • Level II: Specialty Care Level I, plus moderate- to high-risk antepartum, intrapartum, and postpartum conditions
  • Level III: Subspecialty Care – Levels I and II, plus care for more complex maternal medical conditions, obstetric complications, and fetal conditions
  • Level IV: Regional Perinatal Health Care Centers – Levels I, II, III, plus on-site medical and surgical care of the most complex maternal conditions and critically ill pregnant women and fetuses throughout antepartum, intrapartum, and postpartum care

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Matching Patients to the Appropriate Level of Care to Reduce Risks and Improve Outcomes

Maternal Levels of Care Verification helps to ensure facilities have the right resources, right staff, right equipment, and right processes in place for a patient’s specific needs and risk level. It verifies that a hospital has what’s needed to mitigate and respond to risks that lead to higher morbidity and mortality in mothers and infants.

  • Provides a standardized description of maternity facility capabilities and personnel.
  • Provides a framework for integrated systems that addresses maternal health needs from basic to high-risk.
  • Ensures hospitals have a plan for assessing risk and referring patients to a higher level of care facility in the event of unexpected obstetric emergencies.
  • Promotes collaboration among area health care organizations with differing levels of maternal care.
  • Encourages Levels III and IV organizations to provide education and training to Levels I and II.

Moreover, the program encourages state and regional authorities to work together, with the input from area obstetric care providers, to determine an appropriate coordinated system of care and policies (e.g., well-defined thresholds for transferring women to higher levels of care facilities) to improve maternal care outcomes in their communities.

What to Expect

Maternal Levels of Care Verification involves a comprehensive on-site review to verify the level of care provided at a hospital.

The Joint Commission provides you valuable feedback and recommendations. Our collaborative approach allows your organization to improve outcomes for your patients, develop stronger relationships with other maternal care providers in your area, and build community confidence in the care you offer.

State Collaborations

States across the U.S. are collaborating with The Joint Commission with the aim of reducing maternal mortality and morbidity through the recognition of Maternal Levels of Care Verification to meet state designation requirements.


 With one-year of funding provided by the Florida Department of Health, the Florida Perinatal Quality Collaborative (FPQC) will pay initial site visit cost and first full year annual fee for any Florida maternity hospital willing to apply for and participate in The Joint Commission’s Maternal Levels of Care Verification Program.



The Georgia Department of Public Health (DPH) is collaborating with The Joint Commission to use The Joint Commission’s Maternal Levels of Care Verification Program in its designation of levels of maternal care for all eligible Georgia hospitals.



Birthing hospitals in Michigan receive funding for a full cycle of Maternal Levels of Care Verification through a State of Michigan-funded grant, administered by the Michigan Health & Hospital Association.



The Missouri Department of Health recognizes The Joint Commission’s Maternal Levels of Care (MLC) Verification Program to meet their Levels of Maternal Care Designation.


ACOG Collaboration

Maternal levels of care verification

The Joint Commission offers Maternal Levels of Care Verification in collaboration with the American College of Obstetricians and Gynecologists (ACOG).

Want to Learn More?

For access to the standards or for other information contact us.

*World Health Organization, 2019