United States birth outcomes in a comparative context

The US currently is seen as ranking poorly in international comparisons of birth outcomes, but many of these comparisons are inappropriate, involving very small countries (Andorra, San Marino) with less than 10,000 births. This presentation will involve a comparison that looks only at 17 industrialized countries with at least 100,000 births and examine how the U.S. compares to these countries on measures of outcome (infant, neonatal and maternal mortality), resources (number of obstetricians and midwives) and process (cesarean births). In these comparisons the US ranks at or near the bottom on infant, neonatal and maternal mortality and is behind only Italy and Portugal in proportion of cesarean births. These differences are not explained by the distribution of maternity care providers in those countries.