Maternal Safety Strategy: Why More Hospitals Are Turning to the OB Hospitalist Model

March 4, 2026 ‐ HealthLeaders Media

By Christopher Cheney

Improving maternal outcomes has become one of the most urgent clinical priorities for U.S. health systems. Yet many hospitals—particularly community facilities—struggle with inconsistent obstetric coverage, physician shortages, and rising clinical risk in labor and delivery units.

New data from OB Hospitalist Group suggests that hospitals using a dedicated OB hospitalist model may see measurable improvements in maternal and infant outcomes, including reductions in severe maternal morbidity, preterm births, and C-section rates.

The report estimates the model generated more than $800 million in combined clinical and economic impact through avoided complications and expanded access to maternity care.

But the strategic issue for CMOs isn’t the report itself. It’s what the hospitalist model represents: a shift toward 24/7 obstetric coverage, standardized clinical protocols, and centralized management of obstetric emergencies. As health systems confront workforce shortages and widening maternity deserts, CMOs are increasingly evaluating whether dedicated OB hospitalist programs can strengthen safety, reduce liability exposure, and stabilize labor and delivery operations.

For clinical leaders, the question is not simply whether hospitalists improve outcomes, it is whether the model can become a scalable infrastructure for maternal care across diverse hospital settings.

The data

The United States performs poorly on key measures of maternal health compared to other high-income countries. In particular, the United States has the highest maternal mortality rate compared to other developed countries, according to The Commonwealth Fund.

OBGH is the country’s largest OB/GYN hospitalist provider. The organization is generating several positive results with its health system and hospital partners, according to OBHG’s 2025 Maternal Health Impact Report. The report, which features data collected from August 2024 to July 2025, includes several key findings:

1,608 infant deaths avoided
1,036 preterm births avoided
500 severe maternal morbidity cases avoided
$40 million in costs avoided from reduced preterm births
$8.7 million in savings from lower C-section rates
$4.4 million in avoided costs from severe maternal morbidity cases
At OBHG-supported hospitals, C-section rates were significantly below the national average: 19.6% C-section rate at OBHG-supported hospitals vs. 26.6% national rate

A core capability that OBHG offers to health systems and hospitals is establishing 24/7 OB/GYN coverage in the hospital setting.

“We work with health systems across the country and identify what their needs are for obstetrical coverage,” says Mark Simon, MD, MMM, CMO of OBHG. “Once we come to an agreement on obstetrical coverage needs, we employ OB/GYNs and certified nurse midwives to work in the hospital setting.”

Recruiting and retaining clinicians in obstetrics and gynecology is a challenge across the country. OBHG has been able to rise to this challenge, according to Simon.

“No. 1, we must be as competitive as possible in the market and make appealing offers to the clinicians who join us,” Simon says. “There is also an appeal to the kind of work that we do. Many obstetricians enjoy providing direct care in hospitals rather than working in an office.”

Employing certified nurse midwives is a crucial component of OBHG’s workforce strategy, Simon explains.

“Certified nurse midwives can provide an excellent level of care, especially when they are working on care teams with physicians,” Simon says. “The combination of physicians and midwives can not only improve outcomes but also ease the burden of drawing on physicians from the labor market.”

OBHG strives to develop strong relationships between its clinicians and the maternal health care team members at its hospital partners. As part of this effort, most OBHG programs at hospitals feature an OBHG physician who serves as a site leader.

“Part of this leader’s role is to build relationships with the OB/GYNs, midwives, and other clinicians who work in a particular community,” Simon says. “That relationship-building responsibility includes having constant communication with local caregivers, discussing patients who are shared between OBHG clinicians and local clinicians, and seeing how we can support local clinicians through the OBHG program.”

Promoting the use of standardized care protocols is one of the ways OBHG is generating positive clinical outcomes at its partner hospitals. Examples of standardized care protocols that OBHG clinicians encourage are in the areas of hypertension and hemorrhage.

“We ensure that OBHG hospitalists work with patients who have high blood pressure during their pregnancies or during labor,” Simon says. “We also work on implementation of hemorrhage protocols to make sure that hospital staff work together as a team when a patient has intrapartum or postpartum hemorrhage.”

Using standardized care protocols is essential to reduce C-section rates, according to Simon.

“We make sure that only patients who truly need a C-section delivery undergo the procedure,” Simon says.

There are several reasons why C-section deliveries should be avoided whenever possible, Simon explains.

“First, a C-section is a surgery, and surgical procedures are associated with risks, including infection, bleeding, and complications such as damaging the bladder and other organs,” Simon says. “Additionally, every time you have a Cesarean delivery, the incision on the uterus must heal, and that incision can become a weak point that leads to rupture of the uterus during a future pregnancy.”

Health system CMO’s perspective on OB hospitalist programs

HCA Healthcare works with OBHG and other OB hospitalist programs.

Having clinicians from OBGH and other OB hospitalist programs at a hospital is particularly beneficial when OB emergencies such as hemorrhage and emergency C-sections occur, according to Cindy Celnik, MD, MBA, CMO of the women’s service line at HCA Healthcare.

“Even if an attending physician is present during an OB emergency, having OB hospitalists provides an extra layer of expertise and a helping hand, which is always helpful in an OB emergency,” Celnik says.

OB program hospitalists are playing important leadership roles at HCA Healthcare hospitals, Celnik explains.

“They lead initiatives such as programs to address postpartum hemorrhage,” Celnik says. “They help us reduce clinical variation and promote standardized care, which leads to better outcomes.”

There is also an efficiency benefit in working with OB hospitalist programs such as OBGH, according to Celnik.

“OB hospitalists can help with a patient’s labor management,” Celnik says. “Community physicians feel more comfortable working in a hospital that has OB hospitalist services.”

In 2025, Celnik says OBHG clinicians supported nearly 15,000 deliveries and more than 750,000 patient encounters at 28 HCA Healthcare hospitals.

“We have seen positive trends at all of our hospitals that have OB hospitalist programs,” Celnik says. “These facilities have strong safety outcomes and strong team dynamics. There also is lower variation in care, reduced care provider fatigue, and improved adherence to protocols.”

Christopher Cheney is the CMO editor at HealthLeaders.

Be the Expert! Share this: