Maternal morbidity has garnered increasing attention as a patient safety issue. This survey of postpartum women elicited reports of adverse events, unanticipated procedures, and sense of betrayal in health care institutions. Patients' reports of adverse events were associated with lack of trust in physicians. Investigators found that patients who reported more engagement in decision-making maintained more trust in physicians than less engaged patients. The authors suggest that shared decision-making may mitigate some of the loss of trust associated with adverse events. A recent Annual Perspective summarized national initiatives to improve safety in maternity care.