Table 3 Practices most recommended for implementation and de-implementation in survey #1, as consolidated by the investigative team

Practices most recommended for implementation

1. Improved postpartum care, including home visiting programs and short interval visits

20

2. Perinatal and postpartum mood disorder screening and management, including collaborative care models

14

3. Standardized, evidence-based practices for management of hypertensive disorders of pregnancy

11

4. Screening for social determinants of health as a part of prenatal care

10

5. Access to midwifery/birthing center services

10

6. Evidence-based practices for prevention of the primary cesarean, including intermittent auscultation

9

7. Telehealth as a form of prenatal/postpartum care, including remote blood pressure monitoring in pregnancy and postpartum

9

8. Contraceptive access across the lifespan, including immediate postpartum LARC

9

9. Standardized, evidence-based practices for the management of obstetric hemorrhage

7

10. Evidence-based practices for screening for and management of maternal opioid use disorder, including patient navigation services

7

11. Doula support

6

12. Implicit/racial bias training for the staff

6

13. Maternal death reporting and review committees

5

14. Group prenatal care and CenteringPregnancy

4

15. Availability of trial of labor after cesarean

3

16. Appropriate use of antenatal corticosteroids in women at risk for preterm birth

2

17. Utilization of prenatal oral health care

2

18. Low-dose aspirin for preeclampsia prevention

2

19. Nutrition and lifestyle education

2

20. Evidence-based practices for active management of labor

1

Practices most recommended for de-implementation

1. Cesarean delivery for low-risk patients

23

2. Routinely discontinuing all psychiatric medications during pregnancy, without medical indication for doing so

22

3. Routine separation of infants and parents at birth

14

4. Routine continuous electronic fetal monitoring

12

5. Routine induction without medical indication

10

6. Unindicated urine drug screening during perinatal care

10

7. Excessive opioid prescribing post-cesarean

10

8. Standard 12–14 prenatal visit schedule for low-risk patients

6

9. Reduced movement in labor

6

10. Oral intake restrictions during labor

5

11. Bedrest for antenatal conditions

4

12. Unindicated ultrasounds

3

13. Maternal oxygen supplementation during labor

2

14. Overuse of vital signs in labor

2

15. Routine amniotomy

1

16. Early screening for gestational diabetes

1