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Abstract: During 1987 the New York State Department of Health prepared a report that showed trends in cesarean childbirth from 1970 through 1986 and analyzed related factors for the period 1984–1986. As a result, a joint task force was formed consisting of members of the state health department, The American College of Obstetricians and Gynecologists, and the Hospital Association of New York State. The task force met regularly through 1988 to discuss obstetric care in New York state. These discussions led to a joint education and research project intended to improve the understanding of the patterns of obstetric care in the state, to assess a method of quality-of-care review of obstetric programs to improve maternal and fetal outcomes, and to establish an educational framework within this review process. The project will continue through June 1990, when recommendations will be made leading to a more formal, continuing review process for ongoing improvements in quality of obstetric care and institutional management.