Labora Rounds · Clinical intelligence
Every finished figure, in one place. Each one comes in two versions: a slide built to be read in two seconds from the back of a room, and a detail version carrying the full data and every source.
Obstetricians, midwives and doulas counted separately, never summed. In 281 counties a midwife is the only person who can deliver — and she cannot perform a caesarean.
What is happening to women, and to the doctors who deliver them.
Eleven wealthy countries, 1915–2020, on one log axis. All of them made birth safer for seventy-five years. Around 1990 the United States alone turned upward.
The federal register of obstetricians rose at every one of five snapshots, 74,530 to 86,556. An NPI is never withdrawn when a physician retires, moves away or dies.
Admission to newborn intensive care rose 17% among full‑term, normal‑weight babies between 2016 and 2024 — more than three times the rise among babies born early. The rise is largest where the need is least.
Where in America there is no longer anywhere to give birth.
At least 1,076 of the 3,107 counties in the lower 48 have no hospital certified to deliver babies. Just over four million women of childbearing age live in them.
Camden, Arkansas lost its maternity unit in January 2026. The federal provider registry now returns no obstetrician anywhere in the county.
Who took what out, and which units went next.
Cerberus bought Steward, sold the buildings, paid itself, and left. Four years later Steward filed for bankruptcy and the maternity and newborn intensive care wards closed.
Twenty maternity units scored at highest risk through mid-2028. Eight of the twenty rent their buildings from the same landlord.