I read a very interesting article today from the New Yorker by Atwul Gawande entitled "The Score" - it focussed a lot on the history of childbirth and the contribution of obstetrics to reducing maternal and infant mortality and morbidity. Specifically, it highlighted the work of an anesthesiologist named Apgar, who had devised the Apgar score. The Apgar score is a measure our of 10 taken at almost every birth at both one minute and five minutes. It gives two points if a baby is pink all over, two for crying, two for taking good, vigorous breaths, two for moving all four limbs, and two for a heart rate over a hundred. A baby with an Apgar of 10 is in good shape - perfect condition. A baby with an Apgar less than 4 is limp, and blue.
It revolutionized infant mortality. All of a sudden there was an immediate concrete measure of how well a baby was doing and a drive to improve that measure.
It is an example of a performance measure that performs well - in that its use enhances the outcomes that are desired.
There are many reasons why this measure is a shining example of what good measurement looks like. It's simple and provides instant feedback on the health status of the infant. Furthermore, it's responsive to the actions of the care providers.
So what would a similar score look like for mom? It might measure how closely moms expectation of birth matched her experience. It might measure her level of pain experienced during and after birth. It might measure the degree of tearing and the adequacy of repair. It might take into account post-birth infection rates. It might also measure adverse events (hemorrhage, shock, etc.). I'm sure maternity care providers, anaesthesiologists, and mothers all would have ideas on what a good composite MomStat would look like...the time for it has come.