OBSTETRICS AND CENTER FOR LABOR AND BIRTH
David Acker, MD, Chief, Obstetrics
Angelleen Peters-Lewis, RN, PhD, Director, CWN Nursing
FACULTY AND STAFF
Faculty, Fellows and House Staff in the Department of Obstetrics and Gynecology,
Independent Practitioners, Harvard Vanguard Physicians and Midwives, BWH Midwives and
CWN Nursing Staff
MISSION
We strive to provide the safest, most culturally sensitive, individualized and professionally
competent obstetric care in the world.
OUR NUMBERS
We are much more than our numbers, but the numbers do provide a snapshot of our clinical
activities. We deliver more than 10% of all babies born in the Commonwealth.
Deliveries By Obstetric Group
FY '06
Harvard Vanguard Medical Associates
MFM Faculty and Residents
Independent Practitioners
BWH Midwives
Total Deliveries
1,453
1,409
4,117
1,052
8,031
Twin Babies
(% of all deliveries)
518
6%
Triplet Babies
(% of all deliveries)
NICU Admissions
(% of all deliveries)
FY '07
1,448
1,693
3,886
1,084
8,111
FY '08
% Change '08 v '07
1,467
1,846
3,598
930
7,841
1%
8%
-8%
-17%
-3%
590
7%
555
7%
-6%
52
1%
36
0.4%
48
1%
25%
857
11%
950
12%
900
11%
-6%
The ancestry of our patients spans every continent in the world. Twelve “official” language
preferences of our patients encompass Arabic to Vietnamese and include American Sign
Language. Deliveries and postpartum care occur in the beautiful, modern Mary Horrigan
Connors Building with its 25 bed (and 4 operating rooms) Labor and Delivery Unit, the 15 bed
Fuller Antenatal Unit and the 75 bed Postpartum Unit.
ACCOMPLISHMENTS IN AY 2008-2009
 Created an Obstetric I.D. Taskforce to promulgate policies for managing infectious diseases
in the intrapartum and postpartum interval.
 Continued to improve our ongoing surveillance and management of obstetric hemorrhage.
The appointment of Dr. Daniela Carusi as Director of Obstetric Surgery will allow us to
focus on a multidisciplinary approach to this serious and growing maternal issue.

Instituted a formal on-line educational program, Electronic Fetal Monitoring, for all staff that
care for intrapartum patients (physicians, nurses, midwives, obstetric anesthesiologists). This
will allow for the use of a common language and shared understanding of this important
surveillance modality.
We continually benchmark our quality measures against national standards and seek to improve
wherever and whenever we can. Below is a sampling of the outcome measurements commonly
utilized and regularly reported to The University HealthSystem Consortium (UHC), an alliance
of 102 academic medical centers and 217 of their affiliated hospitals representing approximately
90% of the nation's non-profit academic medical centers.
O b stetr ic Pra ct ic e Pe rf o r ma nce M ea su re s
July 2007 - June 2008 (unadjusted)
Birth Trauma Rate
Includes a variety of injuries that range in severity from mild
to serious. Each case is reviewed.
3rd and 4th Degree Laceration Rate
Lacerations are almost invariably linked to episiotomy. The
incidence of this procedure is slowly declining
30 Day Re-Admission Rate
Reflects medical and surgical clinical conditions inherent in a
tertiary care institution. There is no standard ‘right’ rate
Spontaneous Vaginal Delivery Rate
Instrument Delivery Rate (total)
The decline in incidence of instrument assisted deliveries
continues
Vacuum Rate
Forceps Rate
Vaginal Delivery w/Prior Cesarean Scar Rate
Nation-wide, the incidence is declining
Primary Cesarean Section Rate
Cesarean rates increase due to societal expectations
BHW
UHC (average)
0.20%
0.30%
2.90%
3.40%
1.70%
1.30%
61.60%
6.00%
64.10%
5.40%
4.90%
1.10%
14.30%
4.00%
1.40%
16.70%
16.40%
16.80%
GOALS FOR AY 2009-2010
The keywords on our Service are SAFETY-IN-OBSTETRICS. Improvement is a constant.
Even as we recruit and retain excellent clinicians, remain sensitive to our patients' individual
needs, improve our technical skills and utilize the most modern modalities of treatment, we
constantly keep in mind that safety for our patients is paramount.