Purpose: This study demonstrates preliminary evidence of the utility of an optimality index as a simple tool for monitoring complications across the perinatal period. Method: The medical records of 147 Latina women participating in a preventive randomized controlled trial for perinatal depression were reviewed for outcomes across the perinatal period. Results: Application of the optimality index found optimality scores ranging from 77.3% to 97.7% in a Latina immigrant population known to have low rates of low–birthweight infants and preterm birth. Optimality scores were significantly lower among women who had a preterm birth or low–birthweight infant. Discussion: The ability of optimality indices to capture within-group variability will allow for a more nuanced understanding of the antecedents and sequelae of negative birth outcomes. Implications for Practice: Increasing reliance on electronic medical records will facilitate the calculation of optimality scores that can be used to track patterns of perinatal health disparities.