pregnant belly

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 conditions
  • Maintain a full range of pediatric medical subspecialists, pediatric surgical subspecialists, and pediatric anesthesiologists at the site
  • Facilitate transport and provide outreach education

View a map or listing of facilities by designation level.