Now, a new study led by researchers at Boston University School of Public Health (BUSPH) and Harvard Medical School-affiliated Beth Israel Deaconess Medical Center (BIDMC) is shedding insight on how hospital organizational structures and staffing within US maternity care may affect the birthing process and possibly contribute to adverse birth outcomes.

Published in the journal PLOS ONE, the study analyzed gestational age patterns and timing of home and hospital births in three high-income countries: the US, which embraces a maternity care model that relies heavily on obstetricians and clinical interventions, and England and the Netherlands, which primarily rely on midwives who provide low-intervention maternity care.

"Our multi-country analysis shows that the US is an outlier in gestational age distribution and timing of low-intervention hospital births," says study lead and corresponding author Dr. Eugene Declercq, professor of community health sciences at BUSPH.

"Every system is perfectly designed to get the results that it gets," says study senior author Dr. Neel Shah, chief medical officer of Maven Clinic and a visiting scientist at BIDMC.

Our study shows that in comparison with other high-income countries, American hospitals may be designed to center the convenience of clinicians more than the needs of people giving birth."

More information: Eugene Declercq et al, The natural pattern of birth timing and gestational age in the U.S. compared to England, and the Netherlands, PLOS ONE(2023).