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During 2007 to 2017

Fertility Rates Down for Each Urbanization Level 2007 to 2017

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Fertility rates decreased from 2007 to 2017 with larger decreases in metro versus rural counties
Women of color have higher rates of severe birth-related health issues compared with non-Hispanic white women

Minority Women at Higher Risk for Severe Maternal Morbidity

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Higher risk for problems seen among black women, women with other health conditions
Global cesarean section rates are increasing

Global Rates of Cesarean Section on the Rise Since 2000

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Articles discuss effects of C-section on health of mothers and children, interventions to reduce use
For nulliparous women receiving neuraxial analgesia

Timing of Pushing Does Not Impact Spontaneous Vaginal Delivery

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Rate of spontaneous vaginal delivery similar for immediate pushing or waiting for 60 minutes
A reduced fetal movement care package does not reduce the risk for stillbirths

Stillbirth Reduction Strategy Unproven

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Care package for reduced fetal movement does not cut stillbirths
Compared with intramuscular pethidine

Patient-Directed IV Remifentanil Cuts Epidural Conversions

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Patient-controlled remifentanil reduces proportion of conversions versus intramuscular pethidine
From 2006 to 2015

2006 to 2015 Saw Increase in Severe Maternal Morbidity

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Forty-five percent increase in rate of severe maternal morbidity at delivery; higher rate for black women
Infant mortality rates in the United States vary substantially by state

CDC: Infant Mortality Rate Varies Greatly Among States

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Low of 3.47 in Vermont to a high of 9.03 in Alabama in infant deaths per 1,000 live births
After cesarean delivery

Skin Microbiota Differ for Obese, Non-Obese Undergoing C-Section

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Obese women have significantly higher bacterial biomass of lower diversity at the incision site
Finding a practice that provides opportunities to do deliveries is a considerable barrier to performing obstetric deliveries

Doctors Have Difficulty Finding Practices Offering Deliveries

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Many family practitioners report that opportunity to do deliveries not available in practice they joined