The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.

The second volume of an overall look at the "malpractice crisis" sheds fresh light on the civil justice and insurance systems, medical liability issues, and their combined effect on health care for mothers and children. Topics include the liability implications of the rising rate of Cesarean sections, an evaluation of the American Medical Association's proposed alternative to the justice system for resolving medical liability disputes, and a review of legislative proposals under consideration.

How the fear of malpractice affects mothers and reproductive choices Giving birth is a monumental event, not only in the personal life of the woman giving birth, but as a medical process and procedure. In The Business of Birth, Louise Marie Roth explores the process of giving birth, and the ways in which medicine and law interact to shape maternity care. Focusing on the United States, Roth explores how the law creates an environment where medical providers, malpractice attorneys, and others limit women’s rights and choices during birth. She shows how a fear of liability risk often drives the decision-making process of medical providers, who prioritize hospital efficiency over patient safety, to the detriment of mothers themselves. Ultimately, Roth advocates for an approach that protects the reproductive rights of mothers. A comprehensive overview, The Business of Birth provides valuable insight into the impact of the law on mothers, medical providers, maternity care practices, and others in the United States.

Prenatal care programs have proven effective in improving birth outcomes and preventing low birthweight. Yet over one-fourth of all pregnant women in the United States do not begin prenatal care in the first 3 months of pregnancy, and for some groupsâ€"such as black teenagersâ€"participation in prenatal care is declining. To find out why, the authors studied 30 prenatal care programs and analyzed surveys of mothers who did not seek prenatal care. This new book reports their findings and offers specific recommendations for improving the nation's maternity system and increasing the use of prenatal care programs.

This is the first part of an in-depth study focusing on medical liability and its effect on access to and delivery of obstetrical care. The book addresses such questions as: Do liability concerns impede the use of new technologies? Have liability issues affected the physician-patient relationship? Are community health and maternity centers being harmed? What specific remedies are being considered and what are their prospects for success?