University of California outlines 3-year initiative to advance equitable maternal care

University of California health leaders described a systemwide initiative to reduce severe maternal morbidity and address racial disparities in maternal outcomes, emphasizing access to prenatal care, standardized evidence-based practices, community partnerships and data-driven interventions.

Dr. David Rubin, executive vice president of health for the University of California, introduced the item and framed it as central to the university’s clinical mission and values: “our true north is really about our mission and our values.” Dr. Robert (Rob) Cherry, interim chief health officer, and Dr. Nerris Benfield, chief medical officer for adult services and professor and vice chair for quality and safety in the department of OB‑GYN at UCSF, described the scope and early findings of the work.

Why UC is acting now

Presenters cited national and state trends and the CDC’s consensus definitions for severe maternal morbidity as the basis for consistent data collection across institutions. Dr. Benfield noted that maternal morbidity and mortality rose during the COVID‑19 spike in 2019–2021 and that, even excluding the COVID effect, the trend has increased. “We have, substantial inequities in maternal care … especially a challenge for our black identified patients,” Benfield said, citing U.S. severe maternal morbidity of about 18 per 100,000 in 2024 and a lower California rate of roughly 10 to 12 per 100,000 in 2024.

Scope and goals

The initiative is structured as a three‑year effort to reduce severe maternal morbidity across the UC system. Dr. Cherry said the program’s objective is to reduce severe maternal morbidity — the CDC‑defined set of delivery or procedural complications that cause significant end‑organ damage — and to narrow disparities between demographic groups. Cherry said one measurable goal tied to the initiative is a 5 percent reduction in severe maternal morbidity among patients who did not receive prenatal care within UC prior to delivery.

Planned interventions

Presenters described a suite of interventions rather than a single policy fix: - Improve timely access to prenatal care, with efforts to reduce wait times and expand screening that identifies high‑risk pregnancies earlier. - Standardize evidence‑based clinical practices across UC sites by embedding CDC‑aligned protocols in electronic medical records and hard‑wiring clinical prompts aimed at conditions that drive severe maternal morbidity (hypertensive disorders, sepsis, acute renal failure, acute cardiac events). - Tailor local solutions to local needs (telehealth and screening in rural areas; doula and community health intermediary programs in urban and migrant communities). - Strengthen partnerships with county health officials, Medi‑Cal plans, federally qualified health centers and community organizations; Dr. Madel Briggs Melanson (chief of health equity, UCHealth) confirmed that discussions with multiple health plans have begun.

Equity focus and evidence

Presenters emphasized that disparities by race and insurance payer are pronounced within UC data, mirroring state and national patterns. Dr. Benfield said internal UC analyses show disparities in severe maternal morbidity for Black‑identified patients, for patients with government payers, and for those with limited prenatal care access. The presenters stressed that some drivers are clinical (rising prevalence of cardiac disease, hypertension, diabetes), and others are social or structural (access, timely prenatal engagement, mental health and substance‑use disorders).

Questions and discussion

Regents and advisors pressed presenters on timelines, measurable targets and accountability. Dr. Cherry said, “this is really a 3 year, initiative. We're in year 1,” and reiterated the 5 percent reduction goal for the specified subgroup. Regents and committee members also asked about doulas and community programs; presenters characterized doula support as an evidence‑based practice the system will seek to scale and to integrate with paid community partners and health plans. Dr. Benfield and Dr. Briggs Melanson described UCSF’s race‑concordant care and doula supports as examples of campus programs that reduced some disparities locally.

Data and measurement issues

Presenters noted that maternal mortality counts are relatively small and that severe maternal morbidity provides greater statistical power for systemwide measurement. Dr. Benfield clarified that severe maternal morbidity is counted for delivery events and for outcomes up to one year postpartum if related to the pregnancy. The UC team said they will leverage UC electronic tools and analytics to identify variation, target conditions with established clinical bundles and monitor progress.

What was not decided

The session was a presentation and discussion; presenters sought feedback and invitations to develop strategic partnerships and local implementation plans. No formal motions or policy changes were recorded on the public transcript.

Why it matters

UC leaders said the initiative aligns clinical quality, equity and access goals across UC medical centers and campuses that serve varied populations. The multi‑pronged approach — earlier access, standardized clinical care, community partnerships and targeted local interventions — is intended to lower severe maternal morbidity and to narrow disparities in outcomes.