Update on Research Issues in the Assessment of Birth Settings

More than 30 years ago, the Institute of Medicine (IOM) and the National Research Council (NRC) convened a committee to determine methodologies and research needed to evaluate childbirth settings in the United States. The committee members reported their findings and recommendations in a consensus report, Research Issues in the Assessment of Birth Settings (IOM and NRC, 1982). An Update on Research Issues in the Assessment of Birth Settings is the summary of a workshop convened in March, 2013, to review updates to the 1982 report. Health care providers, researchers, government officials, and other experts from midwifery, nursing, obstetric medicine, neonatal medicine, public health, social science, and related fields presented and discussed research findings that advance our understanding of the effects of maternal care services in different birth settings on labor, clinical and other birth procedures, and birth outcomes. These settings include conventional hospital labor and delivery wards, birth centers, and home births. This report identifies datasets and relevant research literature that may inform a future ad hoc consensus study to address these concerns.

• Front Matter
• 1 Introduction
• 2 Context and Background
• 3 Assessment of Risk in Pregnancy
• 4 Birth Settings and Health Outcomes: State of the Science
• 5 Workforce Issues
• 6 Data Systems and Measurement
• 7 Costs, Values, and Reimbursement Issues Associated with Various Birth Settings
• 8 Perspective from Providers
• 9 Workshop Reflections: Moving the Research Agenda Forward
• References
• Appendix A: Workshop Agenda
• Appendix B: Moderator and Speaker Biographical Sketches
• Appendix C: Abbreviations and Acronyms