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 increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.

Each year in the United States approximately 440,000 babies are born premature. These infants are at greater risk of death, and are more likely to suffer lifelong medical complications than full-term infants. Clinicians and researchers have made vast improvements in treating preterm birth; however, little success has been attained in understanding and preventing preterm birth. Understanding the complexity of interactions underlying preterm birth will be needed if further gains in outcomes are expected. The Institute of Medicine's Roundtable on Environmental Health Sciences, Research, and Medicine sponsored a workshop to understand the biological mechanism of normal labor and delivery, and how environmental influences, as broadly defined, can interact with the processes of normal pregnancy to result in preterm birth. This report is a summary of the main themes presented by the speakers and participants.

"Now with a new afterword by the author"--Back cover.

A powerful and empowering memoir of a woman's fight to bring her fifth pregnancy to full term after years of heartbreak and horrific loss. To Full Term is the gripping memoir of Darci Klein's pregnancy with her son Sam, and the story of one woman's struggle to give her baby a fighting chance. From refusing to accept outmoded obstetric guidelines to going head-to-head with stubborn medical professionals, to overcoming her own paralyzing fears, Darci faced each challenge to achieve her goal. What she learned on her journey about defending her own reproductive health and coping with the emotional strain of high-risk pregnancy will empower any woman who wants to do all she can to have a full-term, healthy baby.

The placenta is fascinating and complex. Basically foreign to the maternal body, it can be thought of as an organ transplanted onto the mother's host tissue. As such it embodies all the principles of tissue acceptance and rejection. Many of the risks of pregnancy and labor have now been eliminated and the placenta is likely to be at the root of many of the dangers to the unborn child that remain. A breakdown of the relationship between the placenta and the maternal tissue may turn out to be the cause of the majority of early lost pregnancies.