The Obstetric Comorbidity Index (OB-CMI) is a database-derived risk assessment tool that identifies women at risk for severe maternal morbidity (SMM). Our nurse-driven program was implemented to prospectively validate the OB-CMI in a clinical setting. We examined the tool’s ability to predict SMM and evaluated its use in a high-volume, high-risk labor and birth unit. Our presentation outlines the implementation and evaluation of the OB-CMI, highlighting the essential role of the nurse in the assessment of maternal risk. We propose objective and consistent risk assessment for SMM using a simple risk quantification tool that can describe maternal risk in a standardized and recognizable format. Consistent use of the tool provides an overview of patients who are at risk on the unit, allowing for appropriate decision making and planning by members of a multidisciplinary care team throughout all phases of care. Staff were educated and trained in the use of the tool. A 1-month pilot program incorporated the tool into the existing workflow using the OB-CMI to lead twice-daily multidisciplinary rounds and nursing hand-offs. Revisions to the tool were made on the basis of nursing feedback. After the pilot, we prospectively collected data to validate the tool for 6 months. At the end of the validation period, a focus group composed of nursing leaders helped create a survey for the nurses to complete that evaluated the tool for ease and feasibility of use. Statistical analysis demonstrated the reliability and predictability of the OB-CMI. Nurses’ survey results revealed the most important functions of the tool, the impact on clinical practice, and challenges within the program. Increased Awareness of Maternal Risk and Improved Communication of Risk were prevalent themes that emerged from the survey. Contemporary obstetric nurses are perfectly positioned to improve the identification of women who are at increased risk of SMM. This simple tool demonstrates the ability of nurses to reliably identify those women who are most at risk for adverse maternal outcomes. Routine risk stratification is necessary to improve the critical state of maternal morbidity and mortality in the United States.