Poor pregnancy outcomes and disparities in the United States are a sign of low-value and ineffective care. Despite spending more for care during pregnancy and childbirth, the United States achieves significantly worse
outcomes with rates of maternal mortality, severe maternal morbidity (SMM), preterm birth and infant mortality
among the highest of any developed country. The structure and content of outpatient prenatal and postpartum care largely emerged from medical opinion and tradition, rather than evidence tying it to better outcomes. In addition, there is abundant evidence that structural, institutional, and interpersonal racism is deeply embedded into U.S. medical care, especially within obstetrics and gynecology.