Purpose: A successful childbirth has increasingly centered upon issues of morbidity and quality of life (QOL) from the maternal as well as the neonatal standpoints. Especially with cases involving macrosomia, since, vaginal deliveries may result in significant injuries to both the mother and newborn. Unfortunately, there exist situations in which the potential health benefits of the mother must be weighed against the potential health benefits of the newborn; for the proper deployment of money, people, time, equipment and knowledge. In this study, we take the initial stride toward objectively determining the optimal deployment of resources in these situations.

Methods: A panel of health professionals assigned QOL scores to (1) conditions affecting the QOL of a mother in isolation, (2) conditions affecting the QOL of a newborn in isolation, and (3) conditions that affect both the mother and newborn collectively (the mother-newborn dyad). Multivariate regression techniques were utilized to determine whose QOL, the mother's or her newborn's is weighted more heavily. This analysis was performed globally as well as stratified by illness severity of the newborn. Least squares error methods were utilized suggesting how health professionals actually assess the QOL of the mother-newborn dyad.

Results: A newborn's QOL is weighted more heavily than their mother's. Overall, the QOL of a newborn is weighted 4.35 as much as their mother's QOL. When a newborn has mild brachial plexus injury their QOL is weighted 0.86 as much as their mother's QOL, when a newborn has moderate brachial plexus injury their QOL is weighted 2.81 as much as their mother's QOL, and when a newborn has severe brachial plexus injury their QOL is weighted 5.84 as much as their mother's QOL. In addition, our analysis indicates that health professionals, when assessing the QOL of the mother-newborn dyad, assesses the QOL of the mother first and then adjust this value based on the illness severity experienced by the newborn.

Conclusions: A newborn's QOL is weighted more than four times as much as their mother's QOL. More importantly, this analysis indicates a mechanism in which to assess QOL at a higher order than the individual level. That is, how to measure spillover effects; the recognition that some health interventions have an effect upon more than the individual receiving the health intervention.