Sleep deprivation: implications for obstetric practice in the United States.

Recent advances in basic science have expanded our understanding of the function of sleep and of the effects of sleep deprivation on human cognitive and psychomotor performance. In addition, a growing volume of data documents potential detrimental effects of sleep deprivation on medical practice. Such data have special implications for a specialty in which sleep deprivation is sometimes the norm. A review of this evidence suggests the pressing need for a reassessment of individual and small group obstetric practice, particularly as it relates to labor and delivery care; the current model of care in which each woman is delivered by the same provider who delivers prenatal care is generally not tenable in a culture increasingly focused on patient safety.