More than 30 years ago, the Institute of Medicine (IOM) and the National Research Council (NRC) convened a committee to determine methodologies and research needed to evaluate childbirth settings in the United States. The committee members reported their findings and recommendations in a consensus report, Research Issues in the Assessment of Birth Settings (IOM and NRC, 1982). An Update on Research Issues in the Assessment of Birth Settings is the summary of a workshop convened in March, 2013, to review updates to the 1982 report. Health care providers, researchers, government officials, and other experts from midwifery, nursing, obstetric medicine, neonatal medicine, public health, social science, and related fields presented and discussed research findings that advance our understanding of the effects of maternal care services in different birth settings on labor, clinical and other birth procedures, and birth outcomes. These settings include conventional hospital labor and delivery wards, birth centers, and home births. This report identifies datasets and relevant research literature that may inform a future ad hoc consensus study to address these concerns.
More than 30 years ago, the Institute of Medicine (IOM) and the National Research Council (NRC) convened a committee to determine methodologies and research needed to evaluate childbirth settings in the United States. The committee members reported their findings and recommendations in a consensus report, Research Issues in the Assessment of Birth Settings (IOM and NRC, 1982). An Update on Research Issues in the Assessment of Birth Settings is the summary of a workshop convened in March, 2013, to review updates to the 1982 report. Health care providers, researchers, government officials, and other experts from midwifery, nursing, obstetric medicine, neonatal medicine, public health, social science, and related fields presented and discussed research findings that advance our understanding of the effects of maternal care services in different birth settings on labor, clinical and other birth procedures, and birth outcomes. These settings include conventional hospital labor and delivery wards, birth centers, and home births. This report identifies datasets and relevant research literature that may inform a future ad hoc consensus study to address these concerns.
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 Institute of Medicine (IOM) of the National Academy of Sciences (NAS) collaborated in this study with the Board on Maternal, Child, and Family Health Research of the Commission on Life Sciences of the National Research Council (NRC) to determine methodologies needed to evaluate current childbirth settings in the United States. Although the proportion of non-hospital births runs as high as 4.4 percent annually in Oregon, insufficient data exist to permit complete evaluation of the various birth settings. The application of good research methods should lead to scientific findings that provide the basis for informed, rational decision making about alternative settings for childbirth. A committee of 11 experts was appointed to review current knowledge, provide background knowledge, and identify the kinds of research designs useful for assessing such matters as the safety, quality of maternity care, costs, psychological factors, and family satisfaction of different birth settings. The committee was also charged with preparing a report that could be used to solicit, evaluate, and fund proposals for studies on childbirth settings. The committee did not design specific studies to be carried out, but rather attempted to point out issues that should be considered by researchers because it believed that the best proposals would arise from investigator-initiated research. Gaps in research could be filled by requests for proposals developed by agency staff and the agency peer review committee. In addition, IOM staff members and several consultants provided background papers for the committee's consideration. The research that results from this report will be useful to policymakers and to consumers searching for information to aid in making decisions about birth settings. Research Issues in the Assessment of Birth Settings summarizes the study.
Written for graduate students and professionals in the fields of midwifery, women’s health, and public health, this book explores the freestanding birth center model in the United States from its conception by pioneering midwives and others in the early 1970s to the present day. Compared to the hospital-based birth model, the freestanding birth center offers a well-documented, healthier, more cost-effective, and more humane way to care for women and newborns, consistent with the goals of the Affordable Care Act. This rapidly expanding model of care has many positive implications for high-quality, individualized care and birth outcomes across the United States. Written by U.S. leaders in midwifery, Freestanding Birth Centers: Innovation, Evidence, Optimal Outcomes offers a comprehensive guide to the evolving role of birth centers, clinical and cost outcomes, regulatory and legal issues, provider and accreditation issues, and the future of the birth center model. Woven throughout the text are descriptions of "exemplar" birth centers representing diverse geographical, business, and service models. These cases illustrate the possibilities for expansion and replication of this model of care. Key Features Provides a thorough history of the birth center movement from its inception through future expansion of the model Serves as an essential resource with up-to-date evidence on clinical and cost outcomes Includes case studies linking the unique service focus of individual birth centers to the associated sections of the book Provides practical and comprehensive coverage of all issues involved in running a U.S. birth center
First Edition an AJN Book of the Year Award Winner! This second edition of a groundbreaking book is substantially revised to deliver the foundation for an evidence-based model for best practices in midwifery, a model critical to raising the United States' current standing as the bottom-ranking country for maternity mortality among developed nations.With a focus on updated scientific evidence as the framework for midwifery practice, the book includes 21 completely new chapters that address bothcontinuing and new areas of practice, the impact of institutional and national policies, and the effects of diversity and globalization. Incorporating themidwifery model of care, the book provides strategies for change and guidance for implementing evidence-based best practices. The book examines midwifery efforts to improve the health of women and children in the U.S., for example, Strong Start, US MERA, Centering Pregnancy, a focus on physiologic birth, and successful global endeavors. It encompasses a diverse nationwide authorship that includes leaders in midwifery,academicians, midwives representing diversity, hospital- and community-based practitioners, and policymakers. This coalition of authors from diversebackgrounds facilitates an engaging and robust discussion around best practices. Chapters open with a contemporary review of the literature, a comparisonof current (often scientifically unsubstantiated and ineffective) practices, evidence-based recommendations, and best practices for midwifery. Key Features: Focuses on scientific evidence as the framework for midwifery practice Addresses continuing and new, controversial areas of practice with strategies and guidelines for change Includes 20 out of 27 completely new chapters Authored by a diverse group of 44 prominent midwifery leaders Examines practices that are in conflict with scientific evidence
The Institute of Medicine (IOM) of the National Academy of Sciences (NAS) collaborated in this study with the Board on Maternal, Child, and Family Health Research of the Commission on Life Sciences of the National Research Council (NRC) to determine methodologies needed to evaluate current childbirth settings in the United States. Although the proportion of non-hospital births runs as high as 4.4 percent annually in Oregon, insufficient data exist to permit complete evaluation of the various birth settings. The application of good research methods should lead to scientific findings that provide the basis for informed, rational decision making about alternative settings for childbirth. A committee of 11 experts was appointed to review current knowledge, provide background knowledge, and identify the kinds of research designs useful for assessing such matters as the safety, quality of maternity care, costs, psychological factors, and family satisfaction of different birth settings. The committee was also charged with preparing a report that could be used to solicit, evaluate, and fund proposals for studies on childbirth settings. The committee did not design specific studies to be carried out, but rather attempted to point out issues that should be considered by researchers because it believed that the best proposals would arise from investigator-initiated research. Gaps in research could be filled by requests for proposals developed by agency staff and the agency peer review committee. In addition, IOM staff members and several consultants provided background papers for the committee's consideration. The research that results from this report will be useful to policymakers and to consumers searching for information to aid in making decisions about birth settings. Research Issues in the Assessment of Birth Settings summarizes the study.
"More than 30 years ago, the Institute of Medicine (IOM) and the National Research Council (NRC) convened a committee to determine methodologies and research needed to evaluate childbirth settings in the United States. The committee members reported their findings and recommendations in a consensus report, Research Issues in the Assessment of Birth Settings (IOM and NRC, 1982). An Update on Research Issues in the Assessment of Birth Settings is the summary of a workshop convened in March, 2013, to review updates to the 1982 report. Health care providers, researchers, government officials, and other experts from midwifery, nursing, obstetric medicine, neonatal medicine, public health, social science, and related fields presented and discussed research findings that advance our understanding of the effects of maternal care services in different birth settings on labor, clinical and other birth procedures, and birth outcomes. These settings include conventional hospital labor and delivery wards, birth centers, and home births. This report identifies datasets and relevant research literature that may inform a future ad hoc consensus study to address these concerns"--Publisher's description.
The primary purposes of this volume are: 1. To provide mental health practitioners with a current overview of our knowledge about normal parental development during pregnancy and its relation to fetal development, with particular emphasis on the impact of acute and chronic stress on these developmental processes. 2. To provide an understanding of the general state of the field of pregnancy and childbirth care both in conventional health systems and in alternative options. 3. To provide an understanding of models of consultation and liaison that are adapt ed to the special conditions of pregnancy and childbirth care, as contrasted to the more traditional modes that characterize these activities in medical and surgical hospitals. If there prove to be secondary gains as a result of pursuing these goals, so much the better. The most desirable of these would be a heightening of awareness of the mental health needs of "pregnant families" and of the risks they incur in transition from non parenthood to parenthood, and a more effective level of primary and secondary prevention of childhood mental disorders. These latter goals are more global and perhaps even a bit grandiose. Their attainment could only be documented through a series of carefully designed research projects aimed at measuring long-range developmental outcome in children and families who have experienced appropriate and early intervention during the pregnancy period.
Praise for the First Edition: “Where was this book when I was a new nurse just learning the ropes of labor and delivery? This is a true gem of a book—a must for any new grad going into labor and delivery. I recommend this book for every labor and delivery floor." -Cindy Curtis, RNC, IBCLC, CCE Former Director, The Family Birth Center Culpeper Regional Hospital Lignum, VA "The best one-stop reference book for the experienced and novice Labor and Delivery RN....Finally an excellent Labor and Delivery book by RN's -- for RN's." -Garla DeWall, RNC Presbyterian Hospital in the Family Birthing Center Albuquerque, New Mexico The clinically oriented guide to nursing care during childbirth is distinguished by its strong focus on evidence-based practice as well as its engaging style and user-friendly format. It reviews the nursing process from admission to delivery focusing on proper surveillance and care, comprehensive data acquisition, interpretation, and teamwork. The second edition continues to help labor and delivery nurses make wise decisions in the delivery room, optimizing both maternal and fetal outcomes. It clearly explains the stages and phases of labor, delivery, and pain assessment and management—all supported by proven research. This text provides authoritative guidance on intervention options, creating patient-centered care plans, and improving communication with other members of the obstetrics team. New to the Second Edition: Proper analysis of the partograph to facilitate appropriate patient interventions Updated information about clinical pelvimetry New information on psyche, including the religious, spiritual, and cultural dimensions of care Setting priorities in triage and care related to postpartum hemorrhage Identification of “myths” related to childbirth Individualized patient care related to fetal distress and nonreassuring fetal status Oxytocin infusion and its relationship to permanent Erb’s palsy and autism Updated information on technology, including connectivity between smart IV pumps and the EMR How to distinguish functional from mechanical dystocia and intervene to enhance fetal and maternal safety Key Features: Applies to nursing care of childbearing clients world-wide Focuses on evidence-based practices Written in engaging, easy-to-understand style for new nurses, seasoned practitioners, and nurses seeking certification Enhances effective decision-making to optimize patient care and outcomes Replete with informative references, relevant graphics, and review questions Incorporates research to clearly explain concepts and best practices Provides orientation fundamentals, checklists, and log charts
