The New York State Perinatal Quality Collaborative (NYSPQC)

When you’re preparing for birth or dealing with a birth injury, understanding the systems in place to protect mothers and babies can help you make informed decisions and know what standards your healthcare providers should be meeting. New York State has been quietly working behind the scenes through a program called the New York State Perinatal Quality Collaborative, or NYSPQC, to make pregnancy and delivery safer for everyone.

This isn’t just bureaucratic paperwork. These are real initiatives that have changed hospital practices, saved lives, and reduced preventable birth injuries across New York. Here’s what you need to know about this program and why it matters for families.

What Is the New York State Perinatal Quality Collaborative?

The NYSPQC is a state-led program run by the New York State Department of Health that brings together hospitals, doctors, nurses, midwives, and other healthcare providers across the state with one goal in mind: making pregnancy, childbirth, and the weeks after birth safer for mothers and babies.

The collaborative works by identifying common problems that lead to poor outcomes, like preventable birth injuries or maternal complications, then developing evidence-based strategies to fix them. Instead of each hospital figuring things out on its own, the NYSPQC creates a network where providers can learn from each other and implement proven safety measures.

The program operates through the Department of Health’s Division of Family Health and partners with regional perinatal centers and birthing hospitals throughout New York State. This structure means that quality improvement efforts reach from major medical centers in New York City to smaller community hospitals in rural areas.

Why Birth Timing Matters and How New York Reduced Early Deliveries

One of the NYSPQC’s most successful initiatives has focused on something that might seem minor but can make a huge difference: making sure babies aren’t delivered too early without a medical reason.

For years, some C-sections and labor inductions were being scheduled before 39 weeks of pregnancy simply for convenience or preference, not because mom or baby needed it medically. Those few weeks matter enormously for brain development, lung maturity, and overall newborn health. Babies born even at 37 or 38 weeks, while technically “term,” face higher risks of breathing problems, feeding difficulties, temperature regulation issues, and even long-term developmental challenges.

The NYSPQC created specific protocols and tracking systems to address this problem, and the results have been remarkable. Among participating hospitals, there has been a 91% decrease in scheduled primary C-sections without medical indication between 36 and 39 weeks of pregnancy.

This dramatic reduction means thousands of New York babies have had those crucial extra weeks to develop properly, lowering their risk of complications that can sometimes lead to birth injuries or longer-term health problems.

What This Means for You

If you’re delivering in a New York hospital, your provider should not be scheduling an elective induction or C-section before 39 weeks unless there’s a clear medical reason. If this is suggested, it’s absolutely appropriate to ask why and what the medical indication is. This is standard practice now, not an unusual request.

How Hospitals Are Reducing Preventable Maternal Complications

The NYSPQC doesn’t just focus on babies. Some of their most important work addresses the leading causes of maternal death and serious injury during and after childbirth.

Two of the biggest killers and causes of serious maternal injury are hemorrhage (severe bleeding) and hypertensive disorders (dangerously high blood pressure, including preeclampsia and eclampsia). The tragic reality is that many of these deaths and injuries are preventable with proper protocols and quick response.

The collaborative has worked with hospitals statewide to implement standardized response protocols for these emergencies. This includes things like:

• Hemorrhage carts stocked with the right medications and equipment in every delivery unit
• Clear protocols for recognizing early warning signs
• Drills and training so every staff member knows their role in an emergency
• Standardized blood pressure monitoring and treatment protocols
• Systems to ensure proper follow-up after discharge

These aren’t glamorous changes, but they’re lifesaving. When every member of the healthcare team knows exactly what to do when bleeding starts or blood pressure spikes, response time drops and outcomes improve dramatically.

Recognizing Warning Signs

While hospitals work on their response systems, knowing warning signs yourself can be crucial. Severe bleeding, blood pressure over 140/90 (especially with headache or vision changes), chest pain, and severe abdominal pain are all reasons to seek immediate care, both during pregnancy and in the weeks after birth. Don’t worry about being overly cautious. These symptoms require evaluation.

The Reality of Racial Disparities in Birth Outcomes and What’s Being Done

One of the most important and sobering aspects of the NYSPQC’s work is confronting the stark racial disparities in maternal and infant outcomes in New York State.

The statistics are difficult to read but essential to acknowledge. Between 2018 and 2020, New York’s overall maternal mortality rate was 19.3 deaths per 100,000 live births. While this is lower than the national average, the disparities are staggering. Black women died at over four times the rate of white women, with 55.8 deaths per 100,000 live births compared to 13.2 for white women.

In New York City specifically, from 2018 to 2022, the pregnancy-associated mortality ratio was 52.3 per 100,000 live births, with a Black-White disparity ratio of 5.3. This means Black mothers in NYC were more than five times more likely to die from pregnancy-related causes than white mothers.

These disparities aren’t explained by health conditions, education level, or income. Research consistently shows that the stress of experiencing racism throughout life, combined with differences in how Black patients are treated in healthcare settings, contributes to these outcomes. Black mothers report being dismissed when they express concerns, having their pain undertreated, and facing assumptions and stereotypes that affect their care.

The Birth Equity Improvement Project

In response to this crisis, the NYSPQC launched the New York State Birth Equity Improvement Project, or NYSBEIP. This initiative requires all birthing hospitals in New York to actively identify and work to eliminate the impact of racism on care and outcomes.

This isn’t a voluntary program or a simple training module. Hospitals must examine their own data, identify where disparities exist in their facility, implement specific interventions to address them, and track whether outcomes improve. The focus is particularly on improving experiences and outcomes for Black birthing people, who face the greatest disparities.

This work includes training staff on implicit bias, creating more inclusive policies, improving communication and respect in patient interactions, and ensuring that concerns raised by Black patients are taken seriously and acted upon promptly.

What This Means for Families

If you’re a Black mother or mother-to-be, these statistics aren’t meant to frighten you but to empower you. You have every right to advocate strongly for yourself, to insist that your concerns be addressed, to ask questions repeatedly until you get satisfactory answers, and to switch providers if you don’t feel respected and heard.

Consider bringing an advocate with you to appointments and delivery, someone who can speak up on your behalf if needed. Document your concerns in writing. If you feel dismissed, say so directly: “I feel like my concern isn’t being taken seriously, and I need you to explain what we’re going to do about this symptom.”

How New York Is Reducing NICU Infections That Can Cause Brain Damage

For babies who need neonatal intensive care, one of the most dangerous risks is infection. Central line-associated bloodstream infections, or CLABSIs, happen when bacteria enter the bloodstream through the IV lines that critically ill babies need for nutrition and medication.

These infections are particularly dangerous for premature or fragile infants. They can cause sepsis, require additional antibiotic treatment, extend hospital stays, and in severe cases, can lead to brain damage or death.

The NYSPQC has implemented specific quality improvement projects focused on reducing CLABSIs in NICUs across the state. This involves strict protocols for:

• How lines are inserted and maintained
• Hand hygiene practices
• When lines should be removed as soon as possible
• Tracking infection rates and investigating each case

The collaborative also works on improving enteral nutrition (feeding through the digestive system rather than IV) for preterm infants, since moving to enteral feeds as soon as safely possible reduces the need for central lines and their associated risks.

These initiatives directly reduce one source of preventable harm that can lead to serious complications and neurological injury in vulnerable newborns.

Why Safe Sleep Education in Hospitals Saves Infant Lives

Sudden unexpected infant death, including SIDS and sleep-related suffocation, remains a leading cause of infant death after the first month of life. While families receive a lot of information during their hospital stay, safe sleep practices are one of the most important things hospitals can teach.

The NYSPQC has implemented a comprehensive safe sleep campaign across New York hospitals that goes beyond just handing out a pamphlet. The program includes:

• Modeling safe sleep from the first moment by always placing babies on their backs in a clear crib
• One-on-one education for every caregiver before discharge
• Demonstrating and having caregivers practice safe sleep positioning
• Addressing cultural practices or family traditions that may conflict with safe sleep guidelines
• Providing resources for families who may not have a safe sleep space at home

The results have been significant. Among participating hospitals, 87% of infants are now being placed in safe sleep environments, and 96% of caregivers receive safe sleep education before discharge. Statewide data shows that areas with comprehensive hospital-based safe sleep programs have seen measurable reductions in infant sleep-related deaths.

Safe Sleep Basics

The safe sleep recommendations are straightforward but worth repeating:

• Always place baby on their back to sleep, for naps and nighttime
• Use a firm sleep surface with a tight-fitting sheet and nothing else in the crib
• No blankets, pillows, crib bumpers, or stuffed animals in the sleep space
• Room-sharing without bed-sharing is safest for at least the first six months
• Keep the room at a comfortable temperature and dress baby in sleep clothing rather than using blankets

These practices dramatically reduce suffocation risk and SIDS risk. They may look different from how previous generations did things, but the evidence is overwhelming that they save lives.

How Quality Improvement Programs Prevent Birth Injuries

Understanding what the NYSPQC does helps you see the bigger picture of birth injury prevention. Many birth injuries are preventable when proper protocols are followed, staff are well-trained, and systems are in place to catch problems early.

The types of initiatives the NYSPQC implements address many of the common causes of birth injuries:

Reducing unnecessary early deliveries means babies are more developed and better able to tolerate labor and delivery, reducing risks of complications that can lead to oxygen deprivation and brain injury.

Improving management of labor complications like hemorrhage and hypertensive disorders means faster response times when emergencies happen, which can be the difference between a good outcome and a catastrophic one.

Standardizing responses to emergencies means that even at 3 a.m. on a holiday weekend, the same high-quality emergency protocols are followed, reducing the variation in care that can lead to injuries.

Reducing infections in vulnerable infants prevents one source of brain damage and developmental injury in babies who are already at high risk.

Addressing racial disparities means working to ensure that all mothers receive the same quality of care, the same rapid responses to complications, and the same respect and attention to their concerns.

What You Can Ask Your Hospital About Quality Improvement

Most people don’t think to ask hospitals about their participation in quality improvement programs, but you absolutely can and should.

When choosing where to deliver or when your baby is in the NICU, consider asking:

• Does this hospital participate in the New York State Perinatal Quality Collaborative?
• What specific quality improvement initiatives are you currently working on?
• What are your rates for early elective deliveries, C-sections, and maternal complications?
• How do your outcomes compare to state averages?
• What protocols do you have in place for maternal emergencies like hemorrhage and preeclampsia?
• What is your NICU’s infection rate?

Hospitals that participate actively in quality improvement programs are more likely to have current, evidence-based protocols and a culture of continuous improvement. They track their outcomes and work systematically to improve them.

You won’t always get detailed answers to all these questions, but asking them signals that you’re an informed patient who expects high-quality care. That alone can sometimes improve the attention and communication you receive.

The National Context and How New York Compares

The NYSPQC is part of a larger national effort. The National Network of Perinatal Quality Collaboratives brings together similar programs from states across the country to share resources, research, and best practices.

This national network allows New York to learn from successful initiatives in other states and contribute its own innovations to the broader effort to improve maternal and infant outcomes nationwide.

New York’s maternal mortality rate of 19.3 per 100,000 live births is lower than the national average, which hovers around 23 to 24 deaths per 100,000 live births. However, rates in many other developed countries are far lower, often under 10 per 100,000, which shows there’s still substantial room for improvement.

The initiatives being implemented through the NYSPQC represent New York’s commitment to continuing to improve outcomes and narrow both the gap with international standards and the unconscionable disparities between different groups of mothers within the state.

Where to Find More Information and Get Involved

If you want to learn more about the NYSPQC’s work or find specific resources, the New York State Department of Health website has information about current initiatives and outcomes data.

For individual families, the most important thing you can do is:

• Choose providers and hospitals that participate in quality improvement initiatives
• Know the warning signs of complications and don’t hesitate to seek care
• Advocate for yourself and bring support people who will advocate for you
• Ask questions about hospital practices and protocols
• Report concerns if you feel your care doesn’t meet safety standards

The work of the NYSPQC happens largely behind the scenes, in hospital committees and quality improvement meetings, in data analysis and protocol development. But the impact is felt in delivery rooms, NICUs, and in the homes of families whose lives look different because a complication was prevented or caught early.

Understanding the Systems That Should Protect You

Knowledge of programs like the NYSPQC doesn’t prevent every complication or birth injury. Childbirth carries inherent risks that can’t be eliminated entirely, and sometimes even with perfect care, outcomes aren’t what we hope.

However, understanding that these systems exist and what they’re designed to do helps you:

• Know what standards your hospital should be meeting
• Recognize when protocols aren’t being followed
• Advocate more effectively for the care you and your baby deserve
• Make more informed choices about where and with whom to deliver
• Understand the broader context if something does go wrong

The NYSPQC’s work represents what’s possible when healthcare providers, hospitals, and state agencies commit to systematic improvement based on evidence and data rather than just continuing to do things the way they’ve always been done.

For families in New York, this means that over the past decade, care has gotten measurably safer. Fewer babies are being delivered too early without medical reason. More hospitals have robust protocols for maternal emergencies. More infants are going home to safe sleep environments. More attention is being paid to ensuring that Black mothers receive the same quality of care and attention to their concerns as everyone else.

These changes didn’t happen by accident. They happened because of deliberate, systematic quality improvement work. And they’re ongoing, which means that care should continue to improve in the years ahead.

When you walk into a New York hospital to give birth, you’re benefiting from this work whether you know about it or not. But knowing about it helps you be a more informed participant in your own care and a more effective advocate when you or your baby need one.