Dr. Shannon M. Clark, MD, FACOG

If there is meconium noted during labor and delivery, that's a question that they should be able to answer. And if they just say, oh, well, meconium happens, that's not a good answer, in my opinion, because they should have protocols on what to do.

People say just like what Kristen said, it's just as safe. Well, I cannot say that about where I work unless I have receipts. In the state of Texas, we have maternal levels of care and we have state guidelines that we have to meet in order to get designated.

People say just like what Kristen said, it's just as safe. Well, I cannot say that about where I work unless I have receipts. In the state of Texas, we have maternal levels of care and we have state guidelines that we have to meet in order to get designated.

People say just like what Kristen said, it's just as safe. Well, I cannot say that about where I work unless I have receipts. In the state of Texas, we have maternal levels of care and we have state guidelines that we have to meet in order to get designated.

Any place in the state of Texas that provides inpatient labor and delivery care has to have a designation, whether that be one, two, three, or four. We are a level four. We have to provide receipts in order to have that designation. That means a robust QAPI plan. QAPI is Quality Assurance Policy Improvement.

Any place in the state of Texas that provides inpatient labor and delivery care has to have a designation, whether that be one, two, three, or four. We are a level four. We have to provide receipts in order to have that designation. That means a robust QAPI plan. QAPI is Quality Assurance Policy Improvement.

Any place in the state of Texas that provides inpatient labor and delivery care has to have a designation, whether that be one, two, three, or four. We are a level four. We have to provide receipts in order to have that designation. That means a robust QAPI plan. QAPI is Quality Assurance Policy Improvement.

And that means we have certain triggers on labor delivery that are mandatory for case review. We chart audit thousands of charts per year. We are gathering data on a continual basis. We have levels of escalation, primary review of certain cases, secondary, tertiary, and beyond. This is something that I do daily with my colleagues. Why aren't birth centers required to do that?

And that means we have certain triggers on labor delivery that are mandatory for case review. We chart audit thousands of charts per year. We are gathering data on a continual basis. We have levels of escalation, primary review of certain cases, secondary, tertiary, and beyond. This is something that I do daily with my colleagues. Why aren't birth centers required to do that?

And that means we have certain triggers on labor delivery that are mandatory for case review. We chart audit thousands of charts per year. We are gathering data on a continual basis. We have levels of escalation, primary review of certain cases, secondary, tertiary, and beyond. This is something that I do daily with my colleagues. Why aren't birth centers required to do that?

Because it's easy to say everything is okay when you don't have to provide receipts to prove it. So I agreed this should be done anywhere that is providing obstetrical care. They have to be able to back up what they're saying.

Because it's easy to say everything is okay when you don't have to provide receipts to prove it. So I agreed this should be done anywhere that is providing obstetrical care. They have to be able to back up what they're saying.

Because it's easy to say everything is okay when you don't have to provide receipts to prove it. So I agreed this should be done anywhere that is providing obstetrical care. They have to be able to back up what they're saying.

And they cannot do that if they're not collecting stats, if they're not reporting their outcomes, their transfer rates, their emergent transfer rates, their complications, the number of postpartum hemorrhages they have, anything like that. We have to have a way to find what those stats are for every birth center, just like I have to do for where I work. And a lot of hospitals do.

And they cannot do that if they're not collecting stats, if they're not reporting their outcomes, their transfer rates, their emergent transfer rates, their complications, the number of postpartum hemorrhages they have, anything like that. We have to have a way to find what those stats are for every birth center, just like I have to do for where I work. And a lot of hospitals do.

And they cannot do that if they're not collecting stats, if they're not reporting their outcomes, their transfer rates, their emergent transfer rates, their complications, the number of postpartum hemorrhages they have, anything like that. We have to have a way to find what those stats are for every birth center, just like I have to do for where I work. And a lot of hospitals do.

This has been proven. to improve patient care and outcomes. The fact that it's that standard that birth centers are required to do that is a disservice to the community because they deserve to know what these stats are. Another thing to consider is if there is a complication in the birth center and they go to the hospital, that stat falls on the hospital.

This has been proven. to improve patient care and outcomes. The fact that it's that standard that birth centers are required to do that is a disservice to the community because they deserve to know what these stats are. Another thing to consider is if there is a complication in the birth center and they go to the hospital, that stat falls on the hospital.

This has been proven. to improve patient care and outcomes. The fact that it's that standard that birth centers are required to do that is a disservice to the community because they deserve to know what these stats are. Another thing to consider is if there is a complication in the birth center and they go to the hospital, that stat falls on the hospital.

If there's a death or patient ends up in hysterectomy or X, Y, and Z, that's going to be on my stats. It's easy to not have to report it if it's not following on your stats. A lot of patients don't even realize that when they're looking at where they're going to give birth. And I'm not trying to throw birth centers under the bus.