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Pregnancy, labor, and birth are normal physiologic processes in women's lives. Women should receive care that supports a physiologic approach, using medical interventions only when needed, and continuing to support normal aspects of pregnancy and birth in more complex situations when possible. The academy supports the normalcy of pregnancy and birth and a woman-centered physiologic approach to providing care on hospital birthing units.

Specialty care for preterm and critically ill infants has evolved over many years. Neonatal intensive care nurseries were developed, and physicians and nurses learned how to provide intensive care for these infants. Neonatal and maternal (in utero) transport to tertiary centers became common in regionalized systems of care to facilitate the specialized care of high-risk neonates when childbirth occurred in settings without specialized personnel or equipment. Annually, nearly 70,000 neonatal transports occur in the United States. Although specialty care helps reduce rates of neonatal mortality, racial disparities and disparities between urban and rural areas exist. The purpose of this article is to review the progress achieved in neonatal and maternal transport over the past 50 years. The knowledge developed can be used to improve the care provided to women, their fetuses, and infants.

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