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A pregnant person leans on a birthing ball with a doula rubbing their lower back. A young child leans on the ball.
Figure 15.1 Laboring Person in a Birthing Center The low-risk person can ambulate and change positions during labor. Some use a doula for support. (credit: by Jefferson Rudy and Agência Senado/flickr, CC BY 2.0)

Labor is a physiologic process that allows the pregnant person to pass from pregnancy to birth and postpartum recovery. This process occurred with little interference until the 20th century, when medical advancements changed the course of labor. Initially, these advancements did not improve maternal or newborn outcomes significantly, but over time, that changed. Worldwide, maternal and newborn outcomes vary greatly, but overall, they have improved significantly (World Health Organization [WHO], 2024). However, the United States is seeing an increase in maternal morbidity and mortality compared to other developed countries (Hoyert, 2023). There is now a call to action to reverse this trend by improving maternal health care in the United States, utilizing best practices, reducing health disparities, and increasing access to care during pregnancy, labor, and the first year postpartum. Nurses are crucial in the implementation of these practices, with a solid understanding of what is normal so that deviations from normal can be identified and quickly treated to improve outcomes.


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