Obstetrics has been plagued by challenges in clinical care, not only historically, but also up to this day. With a combined approach, using technology as a tool, a holistic approach to problem solving, adopting concepts from other fields of science and, along with new educational training concepts for medical professionals, we can meet some of the challenges of classic obstetric problems with new innovative thinking and solutions. By focusing on developing synergistic strategies throughout the antenatal, intrapartum, and postpartum periods of pregnancy, targeting specific perinatal pathologies and complications, we can improve maternal and neonatal outcomes. With this concept in mind and by aiming solutions to specific patient populations and obstetric scenarios, a reduction in the incidence of complications can be realized in the short and long term. Specific targets include the following; (i) improving the management of twin pregnancies with the leading twin in breech position through the use of external cephalic version (ECV) and with the new concept of stimulating fetal primitive reflexes under sonographic control, (ii) identifying the uterine anomalies that are present in breech pregnancies at term which would benefit from delivery planning and follow up care in the short and long term, (iii) using ultrasound intrapartum to improve the safety of rotational deliveries in the second stage of labor thereby avoiding late secondary cesarean section (CS) and improving maternal outcomes, (iv) applying the mathematical concept of vector forces to facilitate improved umbilical cord traction by retained placenta delivery and thereby reducing postpartum bleeding risk and complications leading to invasive surgical measures, and finally (v) the use of high-fidelity simulation training to improve the recognition of common mistakes made by health care professionals in the management of postpartum hemorrhage so that the risk of complications and maternal mortality is reduced. There is no other time in life when a woman or a baby is at greater risk of death or significant morbidity than at and around the time of birth. Since the beginning of recorded history, this has been documented and despite the advances in care and interventions to improve outcomes, it continues, even though to a certain extent reduced, to remain a continuous challenge.
