 Hi everyone. My name is Jill Arnold and I'm the Executive Director of the Maternal Safety Foundation and I'm very happy to present our commitment to the Patient Safety Movement Foundation here today. American women are 50 percent more likely to die in the perinatal period than their mothers were. Last month, a bill called the Preventing Maternal Deaths Act of 2018 passed both the House and the Senate with unanimous support and was signed into law. The new law will allow Health and Human Services to fund state-level efforts to further analyze maternal deaths. It is estimated that four out of five of these maternal deaths occur not in childbirth but in the weeks before and after birth. And it's estimated that about half of the deaths that occur post birth are totally preventable. The maternal mortality is just the tip of the iceberg. CDC reports that around 50,000 maternal near misses occur annually. In September 2018, the Maternal Safety Foundation partnered with the Patient Safety Movement Foundation to publish state dashboards on cesareanrates.org to show each state's progress toward meeting the Healthy People 2020 goal for cesarean utilization as well as state-by-state data on maternal morbidity. This year, we commit as an organization to continue publishing meaningful data that engages patients, families, and the public to raise awareness as well as data that fosters a culture of accountability. The state-level data that we published has been helpful and educational but we're going for more granularity this year. There's a gap in measurement, a blind spot, that is impeding improvement of conditions for 600,000 patients every year. As a result of decades of overuse of the cesarean section, we have changed the birthing population in the United States. In 1980, an estimated 5% of women having babies each year had a previous cesarean birth. Now that percentage is 15% or 600,000 of the 4 million births annually. Women with a previous cesarean are at a higher risk of placental disorders which are associated with maternal morbidity and death. The risk for developing this potentially deadly condition increases dramatically with each repeat cesarean section. And in spite of this knowledge, our preliminary analysis of hospital data shows that half of hospitals do not make the option of vaginal birth after cesarean or VBAC available to patients. What is troubling is that many large tertiary care centers that pride themselves on treating complicated maternal and fetal cases have very low VBAC rates. Current professional guidelines state that any hospital that offers maternity services, including emergency cesarean births, can also manage a vaginal birth after a previous cesarean. But as a result of decades of overuse of cesarean births and lack of accountability and transparency around the unavailability of VBAC across the country, even in these high acuity facilities, we have allowed placenta accretive spectrum disorders and maternal morbidity to climb at the population level. And it's up to all of us to turn this trend around. Our commitment to transparency includes publishing hospital-level VBAC rates with a goal of identifying opportunities for improvement in your communities. For those hospitals that safely support VBAC, we will acknowledge and incentivize their ongoing success with our maternal centers of excellence program beginning this summer. We ask everyone gathered here today, hospital and health system leaders, providers, health technology innovators and patient advocates to join us and the patient safety movement in using data to drive change. There are three actionable patient safety solutions for obstetric safety on the Patient Safety Movement website, as well as an unprecedented number of patient safety bundles and QI toolkits available for free elsewhere. Use them. Implement them. Be a champion for maternal safety in your organization because our collective engagement and quality improvement will make the perinatal period safer for moms and babies everywhere. Thank you.