According to the Oxford English Dictionary, the word obstetrics is defined as “that branch of medicine that deals with childbirth and the care and treatment of the mother before and after birth.” Its derivation is from the Latin obstetrix, meaning midwife—from “mid”—with, and “wif”—meaning woman. Petraglia (2008) describes evidence of midwifery from records found in ancient Egypt and the Roman Empire. The Egyptian Ebers Papyrus (1900 to 1550 BC) recognized midwifery as a female occupation concerned with obstetrics and gynecology, and specifically with the acceleration of parturition and the birth process. Petraglia further reports that midwifery services were described through the Middle Ages and into the 18th century, at which time the role of the surgeon superseded that of the midwife. It was at this time that medicine began to assert that its modern scientific processes were better for mothers and infants than those of folk-medical midwives.
In the contemporaneous sense, obstetrics is concerned with reproduction of humans. The specialty promotes health and well-being of the pregnant woman and her fetus through quality prenatal care. Such care entails appropriate recognition and treatment of complications, supervision of their labor and delivery, ensuring care of the newborn, and management of the puerperium to include follow-up care that promotes health and provides family planning options.
The importance of obstetrics is attested to by the use of maternal and neonatal outcomes as an index of the quality of health and life in human society. Intuitively, indices that reflect poor obstetrical and perinatal outcomes would lead to the assumption that medical care for the entire population is lacking. With those thoughts, we now provide a synopsis of the current state of maternal and newborn health in the United States as it relates to obstetrics.
The National Vital Statistics System of the United States is the oldest and most successful example of intergovernmental data sharing in public health. The National Center for Health Statistics (NCHS) collects and disseminates official statistics through contractual agreements with vital registration systems operated in various jurisdictions legally responsible for registration of births, fetal deaths, deaths, marriages, and divorces. Legal authority resides individually with the 50 states; two regions—the District of Columbia and New York City; and five territories—American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the Virgin Islands. Schoendorf and Branum (2006) provide a thoughtful review of the use of these statistics to conduct obstetrical and perinatal research.
Standard certificates for the registration of live births and deaths were first developed in 1900. An act of Congress in 1902 established the Bureau of the Census to develop a system for the annual collection of vital statistics. The Bureau retained authority until 1946, when the function was transferred to the United States Public Health Service. It is presently assigned to the Division of Vital Statistics of the NCHS, which is a division of the Centers for Disease Control and Prevention ...