Quality assurance in maternity care is a valuable activity; it frequently leads to changes in the way health care in provided so that women and their families experience a better maternity service and/or better health outcomes. The term ‘quality assurance’ encompasses activities such as ‘peer review’, ‘root cause analysis’ ‘quality improvement’ and ‘audits;’ including chart and data base audits. An increasing number of quality assurance papers are being submitted for possible publication in Women and Birth. This has raised questions and concerns among editors and reviewers. The question for me as editor in chief then is, under what circumstances is quality improvement research of sufficient ethical and scientific quality to allow it to be published in this journal?