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Link to the OBI Registry:

The Obstetrics Initiative (OBI) Registry provides data reports to help you understand your hospital’s cesarean delivery and vaginal delivery rates for “low” and “non-low” risk groups of patients [ref], and assess maternal and fetal outcomes after adjusting for your patient population. These reports can also help hospitals monitor maternal and neonatal outcomes after implementing interventions to improve maternity care quality and support vaginal birth. The Obstetric Reports are optimized for peer-to-peer comparison and monitoring trends over time. Our reports provide data-driven insights into areas for focused quality improvement.

OBI Data Sources

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Insurance claims data for patients treated at 66 Michigan maternity hospitals. Includes beneficiaries covered by Preferred Provider Organization (PPO) and Blue Care Network (BCN).


Birth certificate data (from MDHHS) matched with inpatient hospital discharge data (from the Michigan Hospital Association). Includes all patients treated at all 81 Michigan maternity hospitals.

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Patient level data on Nulliparous, Term, Singleton, Vertex (NTSV) patients from OBI Hospitals (starting Fall 2019).

Cesarean Delivery rates

Nulliparous Term Singleton Vertex (NTSV) Cesarean Delivery Rate: Using birth certificate data from the Michigan Department of Health & Human Services, the NTSV Cesarean Delivery rate is the percentage of nulliparous women who have a Cesarean Delivery and who are term (>=37 weeks gestation) with a singleton, vertex gestation. 

Society for Maternal Fetal Medicine (SMFM) Cesarean Delivery Rate: Using claims data for the Preferred Provider Organization (PPO) patients in Blue Cross Blue Shield (BCBS), the SMFM Cesarean Delivery rate is the percentage of women who have a Cesarean Delivery and who are term (>=37 weeks) with a singleton, vertex, live born gestation and without a relative or absolute contraindications to vaginal delivery.



  1. Obstetrics Hospital Summary Report 

  2. Maternal Outcomes Report

  3. Maternal Utilization Report

Birth certificate data REPORTS

  1. ntsv rate trend report

  2. ntsv ranking report

These two NTSV reports were created using Michigan Birth Certificate data. Due to the nature of this data source, which contains all Michigan-born infants, all payers are included (Medicaid, Private Insurance, Self-Pay, and other payment source). Therefore, the two NTSV reports should provide a good picture of all births that took place at your health system regardless of payer.

definitions & References

Low-Risk vs. Non-Low Risk Definitions: ICD-9 & ICD-10 codes

Low-Risk for Claims Data: Comparing variation in hospital rates of cesarean delivery among low-risk women using 3 different measures. Armstrong, Joanne C. et al. American Journal of Obstetrics & Gynecology, February 2016, 214:2, Pages 153–163.

Severe Maternal Morbidity (SMM) Definitions: ICD-9 & ICD-10 codes

Nulliparous, Term, Singleton, Vertex (NTSV)

Nulliparous, Term, Singleton, Vertex (NTSV)