Maternal
Levels of maternal care
Also called: ACOG levels of maternal care, risk-appropriate maternal care
ACOG and SMFM define four levels of maternal care, from basic (Level I) to regional perinatal health care centers (Level IV), so that each pregnant patient delivers where her risks can be managed.
The American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) describe a system of risk-appropriate maternal care with four levels, plus accredited birth centers. Level I is basic care for low-risk pregnancies. Level II is specialty care. Level III is subspecialty care for complex conditions. Level IV is a regional perinatal health care center that can care for the most critically ill patients and supports the facilities around it.
The goal is that each patient delivers at, or is transferred to, a facility whose resources match her risks, such as placenta accreta spectrum, severe preeclampsia or serious heart disease.
In practice, access depends on geography. In rural areas the nearest higher-level facility may be hours away, which is why drive time to each level is a common measure of access.
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Educational reference. Not medical advice and not for clinical decision-making.