Background and History

The WSPC has a long and robust history of perinatal quality improvement in Washington state. From its early beginnings as a subcommittee to an expansive statewide entity, we have remained committed to improving the health of Washington’s pregnant and postpartum people, their infants, and their families.

This timeline provides a brief overview of our history as a collaborative and some initiatives we have implemented.

1960s – 1970s

  • Numerous studies demonstrate that timely access to risk-appropriate neonatal and obstetrical care could reduce perinatal mortality; the March of Dimes Committee of Perinatal Health publishes the first edition of Toward Improving the Outcome of Pregnancy (TIOP I). The most recent rendition (TIOP III) was released in 2010.


  • The Washinton State Department of Health (DOH) establishes the Perinatal Regional Network.
  • The DOH forms the Perinatal Advisory Committee (PAC).

2007 – 2009

  • The Perinatal Regional Network shifts its focus from providing education and consultation to implementing quality improvement initiatives.
  • The PAC establishes a subcommittee in response to the rise in c-section rates and poor birth outcomes. This committee is called the Washington State Perinatal Collaborative (WSPC).
  • March of Dimes, with support from WSPC, launches Healthy Babies are Worth the Wait (2009 – 2014).

2010 – 2011

  • DOH launches an investigation into the rise of anencephaly in Yakima, Benton, and Franklin counties. This investigation initiated a series of activities to promote folic acid messaging across the state (2010 – 2017).
  • WSHA and the Health Care Authority establish the Medicaid Quality Incentive program.
  • The Obstetrical Care Outcomes Assessment Program (OB COAP) program is launched by Foundation for Healthcare Quality.

2012 – 2014

  • The PAC officially changes their name to the Washington State Perinatal Collaborative.
  • WSHA launches the Safe Deliveries Roadmap program.
  • The Bree Collaborative publishes its Obstetrics Care Topics Report & Recommendations. This report influenced quality improvement initiatives related to elective deliveries, inductions, and C-section rates.
  • The WSPC begins works to reduce elective Cesarean (C-section) deliveries before 39 weeks’ gestation (2014 – 2018).
  • The Alliance for Innovation on Maternal Health (AIM) launches nationwide to “support best practices that make birth safer, improve maternal health outcomes and save lives”.

2016 – 2017

  • The Washington State Legislature establishes the Maternal Mortality Review Panel (MMRP) within the Department of health.
  • WSHA launches Maternity Watch, a statewide initiative to optimize early recognition and response to maternal warning signs for causes of maternal morbidity and mortality.

2018 – 2020




  • The Safe Deliveries Roadmap program implements TeamBirth across Washington State birthing hospitals (2023 – 2026)
  • The Washington Blue Band initiative is launched in healthcare facilities across the state.
  • The WSPC supports the work of Smooth Transitions to improve hospital transfers from planned community-based births.