The Virginia Neonatal Perinatal Collaborative (VNPC) was established in 2017 as the 42nd state perinatal quality collaborative (PQC) to improve maternal and infant health outcomes for all pregnant and parenting people, their families, and their infants. The VNPC’s mission aims to ensure that every pregnant and parenting person has the best possible perinatal care and that every infant across Virginia is cared for in a way that gives them the best possible start to their lives. To accomplish this, the VNPC utilizes an evidence-based, data-driven collaborative process that brings together pregnant people and their families, maternal health providers, and state leadership to iteratively strengthen maternal health practices across a wide range of metrics. This report details the work that the VNPC completed in 2023.