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|Abstract:||The World Health Organization (WHO) conducted a systematic review of studies comparing cesarean rates and outcomes, and found that “at population level, cesarean section rates higher than 10 percent are not associated with reductions in maternal and newborn mortality rates.” WHO recommends the use of the Robson classification system as a global standard for monitoring and comparing cesarean section rates over time, and between populations; see WHO statement on cesarean section rates at: http://apps.who.int/iris/bitstream/10665/161442/ 1/WHO_RHR_15.02_eng.pdf?ua=1. A recent editorial published in The New England Journal of Medicine discusses the implications of Great Britain’s recent National Institute for Health and Care Excellence (NICE) recommendations on place of birth (http://www.nice.org.uk/guidance/cg190) for the American childbirth experience. The article states: “The safety argument against physician-led hospital birth is simple and compelling: obstetricians, who are trained to use scalpels and are surrounded by operating rooms, are much more likely than midwives to pick up those scalpels and use them.” The article also highlights the importance of home birth taking place within an integrated medical care system within which collaboration and patient transfers between providers are supported; see A NICE Delivery—The Cross-Atlantic Divide over Treatment Intensity in Childbirth at: http://www.nejm.org/doi/ pdf/10.1056/NEJMp1501461. The World Health Statistics, 2015 report, published by WHO, measures progress toward achieving the Millennium Development Goals. Since 1990, both child and maternal deaths have almost halved, but both will fall short of the goals of a two-thirds reduction in child deaths and a three-quarters reduction in maternal deaths by 2015; see http://www.who.int/gho/publications/world_ health_statistics/2015/en/. Early pregnancy loss occurs in about 10 percent of clinically recognized pregnancies, according to a new Practice Bulletin from the American College of Obstetricians and Gynecologists (ACOG); see http://journals. lww.com/greenjournal/Citation/2015/05000/Practice_ Bulletin_No__150___Early_Pregnancy_Loss.46.aspx. ArecentWorld Health Organization report on: Strategies toward ending preventable maternal mortality, calls for a two-thirds reduction in global maternal mortality by 2030. Efforts to reduce maternal mortality should be grounded in a human rights approach, and focus on eliminating inequities that lead to disparities in health care access and quality, as well as to disparities in health outcomes between and within countries; see http://who.int/ reproductivehealth/topics/maternal_perinatal/epmm/en/. The WHO also released their progress report on the Every Newborn Action Plan started in May 2014; see http:// www.unicef.org/media/media_81931.html. A related article on Quality of care for pregnant women and newborns—the WHO vision was published in the British Journal of Obstetrics and Gynaecology; see http://onlinelibrary.wiley.com/ doi/10.1111/1471-0528.13451/abstract. Joint guidelines on Transforming Communication and Safety Culture in Intrapartum Care were issued by ACOG, the American College of Nurse-Midwives, the Association of Women’ Health, Obstetric and Neonatal Nurses, and the Society for Maternal-Fetal Medicine. The guidelines note that problems in human factors, communication, and leadership are the leading contributors to severe adverse events in perinatal care. Creatin|
|Appears in Collections:||Birth 2015|
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