Plough AC, et al. – The purpose of this study is to characterize, measure, and describe key competencies of managing labor and delivery units in the United States and evaluate the relationship between unit management and maternal outcomes. Labor and delivery unit management varies dramatically across and within hospitals in the United States. Some proactive management practices could be related to increased risk of primary cesarean delivery and maternal morbidity. Other proactive management practices may be related to reduced risk of prolonged length of stay, showing a potential opportunity to safely improve labor and delivery unit efficiency. .