Levels of Care

This page outlines the various Levels of Care for risk-appropriate perinatal services, categorized by both maternal and neonatal capabilities. It serves as a guide for understanding the different designations of facilities, ranging from basic birth centers to specialized regional hospitals (Level IV) for high-risk mothers and infants.

Level of Care Map

View a map or listing of facilities by designation level.

Map

Maternal Levels of Care

Birth Center

Care for low-risk women with uncomplicated singleton (one baby) term vertex (head down) pregnancies who are expected to have an uncomplicated birth

Level I: Basic Care

Care for low to moderate-risk pregnancies

Demonstrates the ability to detect, stabilize, and initiate management of unanticipated maternal-fetal or neonatal problems that occur during the antepartum, intrapartum, or postpartum period until the patient can be transferred to a higher level of care

Level II: Specialty Care

Level I, plus;

Care for moderate- to high-risk antepartum, intrapartum, and postpartum conditions

Level III: Subspecialty Care

Levels I and II, plus;

Care for more complex maternal medical conditions, obstetric complications, and fetal conditions
Provide a full range of advanced imaging
Provide access to a full range of subspecialists, surgical specialists, and anesthesiologists

Level IV: Regional Perinatal Health Care Centers

Levels I, II, III, plus;

On-site medical and surgical care of the most complex maternal/neonatal conditions
Full range of obstetric and pediatric subspecialists, surgical specialists, anesthesiologists, and ophthalmologists on staff
Facilitate transport and provide outreach education

Neonatal Levels of Care

Level I: Well Newborn Nursery

Provide neonatal resuscitation at every delivery
Stabilize and care for infants born 35-37 weeks gestation who remain physiologically stable
Stabilize newborn infant who are ill and those born < 35 weeks gestation until transfer to a higher level of care

Level II: Special Care Nursery

Level I, plus;

Provide care for infants born ≥ 32 weeks gestation and weighing ≥ 1500 g who have physiologic immaturity or who are moderately ill with problems that are expected to resolve rapidly and are not anticipated to need subspecialty services on an urgent basis
Provide care for infants convalescing after intensive care
Provide mechanical ventilation for brief (<24 hours) or continuous positive airway pressure or both
Stabilize infants born before 32 week gestation and weighing < 1500 grams until transfer to a Neonatal Intensive Care Unit (NICU)

Level III: NICU

Level II, plus;

Provide sustained life support
Provide comprehensive care for infants born <32 weeks gestation and weighing <1500 grams and infants born at all gestational ages and birth weights with critical illness
Provide prompt and readily available access to a full range of pediatric medical subspecialists, pediatric surgical specialists, pediatric anesthesiologists, and pediatric ophthalmologists
Provide a full range of respiratory support that may include conventional and/or high-frequency ventilation and inhaled nitric oxide
Perform advanced imaging, with interpretation on an urgent basis, including computed tomography, MRI, and echocardiography

Level IV: Regional NICU

Level III, plus;

Located within an institution with the capability to provide surgical repair of complex congenital or acquired condition
Maintain a full range of pediatric medical subspecialists, pediatric surgical subspecialists, and pediatric anesthesiologists at the site
Facilitate transport and provide outreach education

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Maternal Levels of Care

Neonatal Levels of Care