Effective maternity care with least harm is optimal for childbearing women and newborns. High-quality systematic reviews of the best available research provide the most trustworthy knowledge about beneficial and harmful effects of health interventions. A large, growing body of systematic reviews is available to help clarify effects of maternity practices, yet these valuable resources are grossly underutilized in policy, practice, education, and research in the United States. Practices that are disproved or appropriate for mothers and babies in limited circumstances are in wide use, and beneficial practices are underused. Rates of use of specific practices vary broadly across facilities, providers, and geographic areas, in large part because of differences in practice style and other extrinsic factors rather than differences in needs of women and newborns. These gaps between actual practice and lessons from the best evidence reveal tremendous opportunities to improve the structure, process, and outcomes of maternity care for women and babies and to obtain greater value for investments. This report points the way to achieving these gains for the large population of childbearing women and newborns and for those who pay for their care.
By Carol Sakala and Maureen P. Corry, Co-published by Childbirth Connection, the Reforming States Group, and the Milbank Memorial Fund