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Obstetrics Guidelines Introduction


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The Clinical Guidelines for Obstetrical Services at CRICO-insured Institutions are intended to provide guidance for clinicians and to support optimal maternal and fetal outcomes for patients receiving care by CRICO-insured clinicians1.  The recommendations for practice included in this document were arrived at through careful consideration of the available evidence. These Guidelines offer a framework for provision of obstetrical care, rather than an inflexible set of mandates. Clinicians involved in obstetrical care must use their professional knowledge and judgment when applying any recommendations to the management of individual patients. These Guidelines are subject to revision at regular intervals as changes in clinical practice evolve.

View the contents page for components of this publication.


Optimal care requires a collaborative process among obstetrical clinicians who respect the right of the patient to make informed decisions for herself and her fetus.


The Guidelines are a codification of:

  • existing best practices,
  • recommendations of the American College of Obstetricians and Gynecologists (ACOG) and the American College of Nurse-Midwives,
  • Guidelines for Perinatal Care (American Academy of Pediatrics and ACOG), and
  • Practice Guidelines for Obstetrical Anesthesia (American Society of Anesthesiologists).

The 2017 revisions to the Clinical Guidelines for the Obstetrical Services were guided by a multi-disciplinary group of clinicians, including obstetricians, nurse leaders, nurse midwives, and anesthesiologists from several CRICO-insured institutions. The clinical leaders of the obstetrical departments of the CRICO-insured institutions have approved the current version of these guidelines. Questions regarding this document should be directed to the Patient Safety Department at CRICO, Boston, Massachusetts.

  1. As of July 2017, the following institutions insured through CRICO provide obstetrical service: Atrius Health, Beth Israel Deaconess Medical Center, Beth Israel Deaconess Hospital Plymouth, Brigham and Women’s Hospital, Cambridge Health Alliance, Cooley Dickinson Health Care, Martha’s Vineyard Hospital, Massachusetts General Hospital, Mount Auburn Hospital, Nantucket Cottage Hospital, Newton-Wellesley Hospital, and North Shore Medical Center
                                           Web Guideline Home Page                          Guideline 1 >>

December 20, 2017
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