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.

This book provides an introduction to the sociological study of midwifery. The readings have been selected to highlight the interplay between midwifery and medicine, reflecting the medicalization of childbirth. It highlights the major themes in both a historical and a current context, as well as western and non-western societies. Two major themes underlie the organization of this book: that the conception of midwifery must be broadened to encompass a sociological perspective; and that the ongoing trend toward the medicalization of midwifery is crucial to an understanding of the historical, current, and future status of midwifery. By medicalization of childbirth and midwifery the author mean the increasing tendency for women to prefer a hospital delivery to a home delivery, the increasing trend toward the use of technology and clinical intervention in childbirth, and the determination of medical practitioners to confine the role played by midwives in pregnancy and childbirth, if any, to a purely subordinate one.

As Puerto Rico rapidly industrialized from the late 1940s until the 1970s, the social, political, and economic landscape changed profoundly. In the realm of heath care, the development of medical education, new medical technologies, and a new faith in science radically redefined childbirth and its practice. What had traditionally been a home-based, family-oriented process, assisted by women and midwives and "accomplished" by mothers, became a medicalized, hospital-based procedure, "accomplished" and directed by biomedical, predominantly male, practitioners, and, ultimately reconfigured, after the 1980s, into a technocratic model of childbirth, driven by doctors' fears of malpractice suits and hospitals' corporate concerns. Pushing in Silence charts the medicalization of childbirth in Puerto Rico and demonstrates how biomedicine is culturally constructed within regional and historical contexts. Prior to 1950, registered midwives on the island outnumbered registered doctors by two to one, and they attended well over half of all deliveries. Isabel M. Córdova traces how, over the next quarter-century, midwifery almost completely disappeared as state programs led by scientifically trained experts and organized by bureaucratic institutions restructured and formalized birthing practices. Only after cesarean rates skyrocketed in the 1980s and 1990s did midwifery make a modest return through the practices of five newly trained midwives. This history, which mirrors similar patterns in the United States and elsewhere, adds an important new chapter to the development of medicine and technology in Latin America.

First published in 1996. Childbirth: Changing Ideas and Practices is intended to pro-vide readers with key primary sources and exemplary historio-graphical approaches through which they can more fully appreciate a variety of themes in British and American childbirth, mid-wifery, and obstetrics. The articles in this series are designed to serve as a resource for students and teachers in fields including history, women’s studies, human biology, sociology, and anthropology. They will also meet the socio-historical educational needs of pre-medical and nursing students and aid pre-professional, allied health, and midwifery instructors in their lesson preparations.

The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.

The World Health Organization is currently promoting a policy of replacing traditional or lay midwives in countries around the world. As part of an effort to record the knowledge of local midwives before it is lost, Midwives and Mothers explores birth, illness, death, and survival on a Guatemalan sugar and coffee plantation, or finca, through the lives of two local midwives, Do�a Maria and her daughter Do�a Siriaca, and the women they have served over a forty-year period. By comparing the practices and beliefs of the mother and daughter, Sheila Cosminsky shows the dynamics of the medicalization process and the contestation between the midwives and biomedical personnel, as the latter try to impose their system as the authoritative one. She discusses how the midwives syncretize, integrate, or reject elements from Mayan, Spanish, and biomedical systems. The midwives' story becomes a lens for understanding the impact of medicalization on people's lives and the ways in which women's bodies have become contested terrain between traditional and contemporary medical practices. Cosminsky also makes recommendations for how ethno-obstetric and biomedical systems may be accommodated, articulated, or integrated. Finally, she places the changes in the birthing system in the larger context of changes in the plantation system, including the elimination of coffee growing, which has made women, traditionally the primary harvesters of coffee beans, more economically dependent on men.

Meticulously documented, Optimal Care in Childbirth pulls back the curtain on medical-model management of childbirth. Written for those who want to practice according to the best evidence, assist women in making informed decisions, or advocate for maternity care reforms, it provides an in-depth analysis of the evidence basis for physiologic care.