Obstetric care is a complex, high-risk heath care environment. This analysis of 64,441 deliveries in Massachusetts in 2019 found that individuals delivering in hospitals with risk-inappropriate resources were more likely to experience severe maternal morbidity. Among the one-third of individuals with a high-risk obstetric condition, 13% delivered at a hospital with inadequate resources for their condition. The authors conclude that hospitals can use a Levels of Care Assessment Tool to better understand their resources and capabilities to ensure that everyone receives risk-appropriate care.