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Applying the ICU approach to obstetrics requires a concentration of equipment, procedures, and personnel that enables fetal-maternal indices to be evaluated in much greater detail than usual. But that the approach may be appropriate for all deliveries is suggested by the finding that perinatal mortality among monitored, high-risk patients is in fact slightly lower than among unmonitored, essentially normal (i.e., low-risk) women.

It is entirely likely, states Dr. Quilligan, that the timing of labor, involving not one but two organisms, is regulated by processes of great complexity. He reviews current theories on the roles of progesterone and oxytocin, of cellular events that take place in the myometrium, and of the relative functions of maternal and fetal endocrine systems in the feedback system that may signal the birth of a baby.