Looking back at pediatrics to move forward in obstetrics

Purpose of review: This review assesses the current status of obstetrical care; discusses the life course health development (LCHD) model and its implications for reorganizing systems of care for women of childbearing age; and looks to the child health system for improvement strategies that can be adapted to women's health and obstetric care. Recent findings: The LCHD model integrates recent evidence on the developmental origins of health and disease across the life span into a robust framework that can inform a more integrated model of healthcare delivery. We now understand how experiences and exposures early in life influence health trajectories throughout life and can use that knowledge to redesign and retool our health systems, including obstetric care. The authors provide examples of how positive health trajectories are being realized in the child health system through evidence-based programs that prevent risk and promote health. Summary: Recently, obstetricians and public health researchers have begun to apply the LCHD model to reconceptualize the development of health trajectories and consider new strategies for improving reproductive outcomes. Recommendations are made for how the LCHD model can be used to reengineer obstetrics and women's healthcare, and offer specific examples of what a system that optimizes women's reproductive readiness would look like.