Improving the use of research-based evidence in policy making: effective care in pregnancy and childbirth in the United States.

The rigorous syntheses in Effective Care in Pregnancy and Childbirth (ECPC) raise the question of how these and future recommendations can effectively be used to influence the decisions of policy makers and to improve the care we receive. The fragmentation of U.S. health care is especially striking for pregnancy and childbirth care. Although the U.S. context does not contain an obvious focal point for ECPC, several organizations have leverage or influence over different facets of policy making in this area: professional associations, consumer advocates, regulatory bodies, and third-party payers. An alternative to current independent activities is the organization of a network to facilitate implementation of ECPC. The intention would be that, through interaction, members would strengthen their interest and improve their effectiveness in implementing ECPC. An initial activity might be to evaluate alternative methods for implementing a specific recommendation.