Over the last few decades, the measurement and reporting of health care quality outcomes has grown significantly. As health care evolves, it is important to continue to monitor and report on the quality of care delivered to patients in California and across the US. This is part of a series of measures CHCF is publishing on the quality of care in the state. Topics range from maternal to end-of-life care, and include measures on behavioral health, chronic conditions, and providers.

This set of quality measures focuses on maternal health and childbirth.

California’s low-risk, first-birth cesarean rate declined from 2013 to 2019.

California’s low-risk, first-birth cesarean (c-section) rate has been declining since 2013 and has been below the Let’s Get Healthy California target since 2018. C-sections, while sometimes necessary, increase the risk of postsurgical complications, including bleeding, infections, and organ damage.¹

Black infants were more likely to be born preterm or at a low birthweight than infants of other races/ethnicities.

In 2019, approximately 12% of Black infants were born preterm or with a low birthweight. Infants born preterm or with a low birthweight have increased risk for lifelong health problems or dying before their first birthday.

Black infants had a higher mortality rate than infants of other races/ethnicities.

Black infants in California had a mortality rate (8.3) that was two times higher than the Let’s Get Healthy California target of 4.0 (not shown) and nearly two times higher than the California average (4.2).

Black birthing people reported higher rates of prenatal and postpartum depressive symptoms than people of other races/ethnicities.

Many Californians suffer from prenatal or postpartum depression, which can negatively impact the birthing person and child. About one in four Black birthing people reported experiencing symptoms of prenatal depression, and more than one in six reported experiencing symptoms of postpartum depression, in 2018 and 2019.

The companion Excel data file is available for download below. These materials are part of CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses describing the state’s health care landscape. See our entire collection of current and past editions of Quality of Care.

1. “My Birth Matters,” California Maternal Quality Care Collaborative.