Maternal and child health care realized many important gains during the 20th century. However, those successes are juxtaposed with the reality of indicators that have plateaued or even worsened in recent decades. Despite the availability of contraceptive technology with failure rates of less than 1%, a consistently high proportion of pregnancies are still unintended (estimated at 49%).1 Maternal mortality has been increasing in some areas such as California, where the rate has doubled in the last decade and was estimated at 16.9 per 100 000 live births in 2006.2 This trend, coupled with the well-documented racial disparities in birth outcomes,3 suggests that the health needs of US women are not being met.
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