Since its founding, CMQCC’s mission has been to end preventable maternal morbidity, mortality, and racial disparities in California for maternity care. Working alongside hospitals, clinicians, public health partners, and communities, CMQCC’s quality improvement toolkits and collaboratives have been successful in reducing maternal mortality in California; however, despite growing awareness of maternal health disparities, significant inequities remain.

Health Equity Initiatives
CMQCC remains committed to working collaboratively with hospitals, patients, families, communities, and public health partners to identify, test, and spread best practices for equitable, respectful maternity care.

After several years of work with a five-hospital pilot's birth equity collaborative and our Birth Equity Task Force, CMQCC launched these efforts to advance respectful care (described below). This experience teaches us that equity-focused quality improvement is complex. Data and protocols matter, but lasting change also requires shifts in mindsets, behaviors, and organizational culture. It is work of the head and of the heart.

CMQCC acknowledges the many health equity pioneers who lead the way, hospital members who continuously improve the care they provide, and patients whose stories and experiences inspire this work.
 

The Hospital Action Guide for Respectful and Equity-Centered Obstetric Care

Now available to the public as of October 27, 2026

With the goal of improving maternal outcomes for all women and birthing people, CMQCC and its partners developed The Hospital Action Guide for Respectful and Equity-Centered Obstetric Care (Hospital Action Guide). First launched in August 2023 for CMQCC California member hospitals, the Hospital Action Guide is now publicly available to hospitals, clinicians, and partners everywhere who are committed to advancing respectful and equitable maternity care.

Hospital Action Guide Executive Summary

The Guide offers a structured, equity-centered framework and practical solutions to strengthen respectful, person-centered maternity care through meaningful partnerships with patients, families, public health agencies, and community organizations. It combines evidence-based practices, implementation strategies, practical tools, reflection activities, and curated resources that hospitals can adapt to the needs of their local communities.

Get Started

Create a CMQCC Account to access the Guide


What’s New
The 2026 public release includes an updated What’s New section highlighting revisions and additions since the original launch. It also adds a Key Terms section that defines the core equity concepts used throughout the guide and helps teams share a common language.
 
The Hospital Action Guide Consists of Six Modules:

1) Understand the Need for Health Equity to Enhance Equity, Reduce Disparities, Increase Safety, and Meet Regulatory and Legislative Requirements
2) Identify Opportunities for Collecting and Sharing Stratified Data on Patient Experience and Outcomes
3) Examine Current Equity Practices to Implement Informed and Meaningful Action
4) Leverage Patient Care Process and Outcome Data to Address Obstetric Disparities
5) Create a Culture of Respectful Care
6) Integrating Community Collaboration
 

Screenshot of homepage of CMQCC's Hospital Action Guide for Respectful and Equity-Centered Obstetric Care

How It Was Developed
Since 2019, CMQCC has worked with hospital partners to develop, implement, and test tools and protocols that advance equitable care and support the consistent delivery of respectful care. The Hospital Action Guide grew out of that work and was refined through extensive reviewer and partner input.

Share Your Feedback
We welcome your insights as you use the Hospital Action Guide. Your feedback is crucial to our collective progress. There are two options in place for feedback:

Upcoming Webinar! From Guidance to Action: The Hospital Action Guide for Respectful and Equity-Centered Obstetric Care – Public Release Webinar
Join us on Monday, November 2 from noon-1 p.m. PT for an engaging conversation highlighting how healthcare professionals, hospitals, and community partners are using the Guide to strengthen partnerships, address implicit bias, and advance respectful, equitable obstetric care.

Register for the Hospital Action Guide Public Release webinar


Learning Initiative to Support Safe and Respectful Vaginal Birth

CMQCC is renewing California’s efforts to reduce cesareans in all low-risk pregnant patients by conducting a statewide hospital collaborative-like learning experience with five-year (September 2022-2027) funding from the Centers for Disease Control and Prevention.

The Learning Initiative to Support Safe and Respectful Vaginal Birth, launched in spring 2023, is focused on reducing disparity gaps in low-risk cesareans with a goal of all patient groups reaching or exceeding the Healthy People 2030 target rate. CMQCC will conduct the Learning Initiative in multiple cohorts for 18 months, starting new rounds every nine months with two cohorts in each round.  

Curriculum for the Learning Initiative will follow the CMQCC Hospital Action Guide for Respectful and Equity-Centered Obstetric Care. To support California hospitals not yet participating in the Learning Initiative, CMQCC has hosted free quarterly webinars teaching key elements of the curriculum and continues to offer additional technical assistance during monthly virtual office hours. Through the Learning Initiative, hospitals can build multidisciplinary teams to foster sustainable change and enhance professional experiences. 

Engaged since 2019, the CMQCC Pilot Health Equity Collaborative members remain helpful and will participate as mentors and guest faculty for the Learning Initiative, a community that is dedicated to promoting respectful obstetric care and health equity.