PURPOSE:
We developed world first co-designed self-report measures of women’s experiences and outcomes of maternity care. Central to this work was the appointment of Australia’s first Maternity Consumer Fellow, elevating and centring the role of lived experience as essential for tool development.

DISCUSSION:
Around the world, midwives work in systems that define safety and quality using short-term clinical metrics—morbidity, mortality, and access to essential care. But these indicators do not capture what matters most to women. Without reliable data on women’s experiences and self-reported outcomes, midwives are limited in their ability to advocate for the systemic reforms urgently needed to deliver respectful, individualised care. While some tools exist, systematic reviews show most are not maternity-specific, lack co-design, and are too long or complex for practical use. Our project used a three-phase mixed methods design to develop globally relevant, co-designed Patient-Reported Experience Measures (PREMs) and Patient-Reported Outcome Measures (PROMs) specific to maternity care. Following international tool development guidelines, phase one included a rapid review, stakeholder consultation, a modified three-round e-Delphi, and cognitive interviews to refine the measures. Phase two involved pilot testing and validation across diverse Australian settings, followed by a second round of cognitive interviews. Phase three focuses on implementation planning and national rollout.

EVIDENCE WHERE RELEVANT:
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KEY MESSAGE:
We cannot improve what we do not measure. The assessment of safety and quality in maternity care is incomplete without measuring the experiences and outcomes reported by those who give birth. If we are to meet the need for one million more midwives, it is essential to also value what counts for the women we care for. These co-designed PREMs and PROMs are critical tools to elevate women’s voices, guide quality improvement, and strengthen midwifery advocacy for systems that uphold the universal right to respectful, woman-centred care. Woman centered 2 (including three-minute presentation competition)