Arthurs Anya L, Harrison Jade K, Williamson Jessica M, Roberts Claire T
College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, SA 5042, Australia.
Flinders Health and Medical Research Institute, Flinders University, Bedford Park, Adelaide, SA 5042, Australia.
J Clin Med. 2025 Aug 18;14(16):5841. doi: 10.3390/jcm14165841.
Over the past two decades, pregnancy and birth trends have undergone significant shifts across Australia, the United States of America (USA), and the United Kingdom (UK), reflecting changes in societal norms, healthcare advancements, and demographic patterns. Variations in maternal age, birth interventions, and fertility rates highlight the evolving nature of reproductive behaviors and healthcare systems in these nations. The analysis reveals consistent increases in maternal age and gestational diabetes, alongside rising caesarean section rates-particularly in private healthcare settings. While perinatal mortality has declined overall, maternal mortality has increased in the USA and remains disproportionately high among Indigenous women and those in ethnic minorities in all three countries. These findings highlight the influence of structural inequities, healthcare access, and policy differences in maternal health. The review underscores the urgent need for equity-focused, culturally safe, and system-level interventions, as well as improved data collection and international collaboration to reduce preventable maternal and neonatal harms. By comparing these three regions, this review aims to provide insights into the shared challenges and unique approaches shaping childbirth practices in high-income countries in the 21st century.
在过去二十年中，澳大利亚、美利坚合众国（美国）和英国的怀孕和生育趋势发生了显著变化，反映出社会规范、医疗保健进步和人口模式的改变。产妇年龄、分娩干预措施和生育率的差异凸显了这些国家生殖行为和医疗保健系统的不断演变。分析显示，产妇年龄和妊娠期糖尿病持续增加，剖宫产率也在上升，尤其是在私立医疗保健机构。虽然围产期死亡率总体有所下降，但美国的孕产妇死亡率却有所上升，并且在这三个国家的原住民妇女和少数族裔中仍然过高。这些发现凸显了结构性不平等、医疗保健可及性和政策差异对孕产妇健康的影响。该综述强调迫切需要以公平为重点、具有文化安全性的系统层面干预措施，以及改进数据收集和国际合作，以减少可预防的孕产妇和新生儿伤害。通过比较这三个地区，本综述旨在深入了解21世纪高收入国家在分娩实践中面临的共同挑战和独特方法。
