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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.
Health Insurance is a Family Matter is the third of a series of six reports on the problems of uninsurance in the United Sates and addresses the impact on the family of not having health insurance. The book demonstrates that having one or more uninsured members in a family can have adverse consequences for everyone in the household and that the financial, physical, and emotional well-being of all members of a family may be adversely affected if any family member lacks coverage. It concludes with the finding that uninsured children have worse access to and use fewer health care services than children with insurance, including important preventive services that can have beneficial long-term effects.
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.
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.
By all indicators, the reproductive health of Americans has been deteriorating since 1980. Our nation is troubled by rates of teen pregnancies and newborn deaths that are worse than almost all others in the Western world. Science and Babies is a straightforward presentation of the major reproductive issues we face that suggests answers for the public. The book discusses how the clash of opinions on sex and family planning prevents us from making a national commitment to reproductive health; why people in the United States have fewer contraceptive choices than those in many other countries; what we need to do to improve social and medical services for teens and people living in poverty; how couples should "shop" for a fertility service and make consumer-wise decisions; and what we can expect in the futureâ€"featuring interesting accounts of potential scientific advances.
"Evidence-based maternity care uses the best available research on the safety and effectiveness of specific practices to help guide maternity care decisions and to facilitate optimal outcomes in mothers and newborns."-- From foreword.
The Republic of Indonesia, home to over 240 million people, is the world's fourth most populous nation. Ethnically, culturally, and economically diverse, the Indonesian people are broadly dispersed across an archipelago of more than 13,000 islands. Rapid urbanization has given rise to one megacity (Jakarta) and to 10 other major metropolitan areas. And yet about half of Indonesians make their homes in rural areas of the country. Indonesia, a signatory to the United Nations Millennium Declaration, has committed to achieving the Millennium Development Goals (MDGs). However, recent estimates suggest that Indonesia will not achieve by the target date of 2015 MDG 4 - reduction by two-thirds of the 1990 under - 5 infant mortality rate (number of children under age 5 who die per 1,000 live births) - and MDG 5 - reduction by three-quarters of the 1990 maternal mortality ratio (number of maternal deaths within 28 days of childbirth in a given year per 100,000 live births). Although much has been achieved, complex and indeed difficult challenges will have to be overcome before maternal and infant mortality are brought into the MDG-prescribed range. Reducing Maternal and Neonatal Mortality in Indonesia is a joint study by the U.S. National Academy of Sciences and the Indonesian Academy of Sciences that evaluates the quality and consistency of the existing data on maternal and neonatal mortality; devises a strategy to achieve the Millennium Development Goals related to maternal mortality, fetal mortality (stillbirths), and neonatal mortality; and identifies the highest priority interventions and proposes steps toward development of an effective implementation plan. According to the UN Human Development Index (HDI), in 2012 Indonesia ranked 121st out of 185 countries in human development. However, over the last 20 years the rate of improvement in Indonesia\'s HDI ranking has exceeded the world average. This progress may be attributable in part to the fact that Indonesia has put considerable effort into meeting the MDGs. This report is intended to be a contribution toward achieving the Millennium Development Goals.
Despite recent declines in infant mortality, the rates of low birthweight deliveries in the United States continue to be high. Part I of this volume defines the significance of the problems, presents current data on risk factors and etiology, and reviews recent state and national trends in the incidence of low birthweight among various groups. Part II describes the preventive approaches found most desirable and considers their costs. Research needs are discussed throughout the volume.
Each year more than 4 million children are born with birth defects. This book highlights the unprecedented opportunity to improve the lives of children and families in developing countries by preventing some birth defects and reducing the consequences of others. A number of developing countries with more comprehensive health care systems are making significant progress in the prevention and care of birth defects. In many other developing countries, however, policymakers have limited knowledge of the negative impact of birth defects and are largely unaware of the affordable and effective interventions available to reduce the impact of certain conditions. Reducing Birth Defects: Meeting the Challenge in the Developing World includes descriptions of successful programs and presents a plan of action to address critical gaps in the understanding, prevention, and treatment of birth defects in developing countries. This study also recommends capacity building, priority research, and institutional and global efforts to reduce the incidence and impact of birth defects in developing countries.