CRICO Connects Patient Safety with Professional Liability in Obstetrical Care

CRICO has long approached medical professional liability with a simple premise: the safest care is also the best protection against malpractice risk.

As CRICO marks 50 years of serving the Harvard medical community, it continues to build programs that connect insurance incentives with evidence-based clinical practice. One of the most enduring examples is the CRICO Obstetrics Patient Safety Program, which aligns malpractice risk reduction with improved care for birthing persons and newborns.

Obstetrics has long been one of the highest-severity areas of medical malpractice risk, both clinically and financially. When adverse events occur during pregnancy, labor, or delivery, the consequences can be profound for families and clinicians alike. Recognizing this, CRICO and leaders across Harvard-affiliated hospitals created a structured approach that combines clinical guidelines, education, and insurance incentives to support safer obstetrical care. In early 2026, CRICO published the latest version of the Clinical Guidelines for Obstetrical Services.

Built by the Harvard Medical Community

The guidelines synthesize best practices and evidence from leading professional organizations—including the American College of Obstetricians and Gynecologists, the American College of Nurse-Midwives, and other specialty societies—to provide practical recommendations for obstetrical care.

Clinicians must apply their professional judgment when caring for individual patients, using the guidance to inform decision-making across the continuum of care.

Every three to four years, CRICO convenes a multidisciplinary advisory committee to review and update the guidelines. The 2026 update was developed with input from obstetricians, nurse leaders, certified nurse midwives, anesthesiologists, , OB Chiefs, and patient safety experts from multiple CRICO-insured institutions. The 2026 revision includes reviewed and updated references reflecting the most current evidence.

Turning Guidance into Practice

The Obstetrics Risk Reduction program is open to CRICO-insured obstetricians, certified nurse midwives, and family physicians with obstetrical privileges. Participants complete a series of risk-reduction activities designed to reinforce best practices and strengthen team readiness for obstetrical emergencies.

Key components include:

• Participation in obstetrical safety drills and team training

• Study of the CRICO OB Clinical Guidelines

• Passing an annual knowledge assessment based on the guidelines

The annual test ensures clinicians remain familiar with current recommendations and any updates introduced in the latest guideline revisions.

Clinicians who successfully complete the program may remain in a lower premium underwriting category, reflecting their participation in structured patient safety activities.

In this way, the program reinforces a fundamental principle of CRICO’s approach to professional liability: aligning incentives with practices that improve patient safety. 

By connecting evidence, education, and incentives, the program demonstrates how a medical professional liability organization can actively support safer care for patients while helping clinicians manage risk.