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Wide disparities in obstetrical outcomes exist between women of different race/ethnicities. The prevalence of preterm birth, fetal growth restriction, fetal demise, maternal mortality and inadequate receipt of prenatal care all vary by maternal race/ethnicity. These disparities have their roots in maternal health behaviors, genetics, the physical and social environments, and access to and quality of health care. Elimination of the health inequities due to sociocultural differences or access to or quality of health care will require a multidisciplinary approach. We aim to describe these obstetrical disparities, with an eye towards potential etiologies, thereby improving our ability to target appropriate solutions. Keywordsdisparities; maternal mortality; obstetrical care; preterm birth; race/ethnicity Racial and Ethnic Disparities in Obstetrical Outcomes and Obstetrical CareProfound racial and ethnic disparities have been documented in many areas of health and health care [1][2][3] . Attempts to rectify these inequities in outcomes and processes of care must begin with an accurate account of their prevalence, and with some attention to potential etiologies. Unfortunately, disparities in obstetrical outcomes and care have persisted over time [4][5][6] . Here, we aim to summarize these obstetrical disparities and their possible origins, with the hope of driving an agenda to resolve them.The manner in which disparities in health and health care should be defined is not always straightforward. In an argument to standardize the definition, Lê Cook and colleagues describe three definitions of disparities in health care. 7 In the first, proposed by the Agency for Healthcare Research and Quality, disparities are defined by the mathematical difference in means or proportions between groups, without the use of statistical models. In the second, the Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. CondensationWidespread racial/ethnic disparities exist in obstetrics; documenting them and understanding potential etiologies will increase the likelihood of eliminating them. NIH Public Access Author ManuscriptAm J Obstet Gynecol. Author manuscript; available in PMC 2011 April 1. NIH-PA Author ManuscriptResidual Direct Effect method, disparities are defined by differences which persist after accounting for all measured potential confounding variables. The last definition, preferred by the authors, is that used by the Institute of Medicine, in which disparities are seen as differences above and beyond those that can be explained by differences in health status between groups. Thus f...

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Mortality among very-low-birth-weight infants was lowest for deliveries that occurred in hospitals with NICUs that had both a high level of care and a high volume of such patients. Our results suggest that increased use of such facilities might reduce mortality among very-low-birth-weight infants.

In 2011, one in three women who gave birth in the United States did so by cesarean delivery (CD). Care providers must understand the trade-offs between CD and vaginal delivery (VD) and the opportunities to avoid overuse of primary CD. Cesarean delivery carries greater risks for maternal morbidity and mortality than does VD, along with risks in later pregnancies. The most common indications for primary CD include labor dystocia, abnormal fetal heart rate (FHR) tracing, fetal malpresentation, multiple gestation, and fetal macrosomia.The latent phase of labor has been considered prolonged at longer than 20 hours and longer than 14 hours in nulliparous and multiparous women, respectively, whereas arrest disorders have been diagnosed in the absence of cervical