The publication is an international standard on the design and operation of an efficient and accurate vital statistics system at national level. It provides guidelines on collection, compiling and disseminating vital statistics. More specifically it contains (a) basic principles for a vital statistics system; (b) uses of vital statistics and civil registration records; (c) topics to be covered in a vital statistics system; (d) sources of vital statistics and how they function; (e) quality assurance in the vital statistics system and (f) strategies in improving civil registration and vital statistics systems in countries. It also informs policy makers and the general public on the importance of vital statistics and hence further improving the vital statistics system.

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.

Disparities in health and health care across racial, ethnic, and socioeconomic backgrounds in the United States are well documented. The reasons for these disparities are, however, not well understood. Current data available on race, ethnicity, SEP, and accumulation and language use are severely limited. The report examines data collection and reporting systems relating to the collection of data on race, ethnicity, and socioeconomic position and offers recommendations.