Post-partum tubal ligation by nurse-midwives and doctors in Thailand.
A shortage of doctors limits the provision of post-partum sterilisation services in rural areas of Thailand. To overcome this problem nurse-midwives with theatre experience were trained to perform post-partum tubal ligation by a mini-laparotomy incision under local anaesthesia. The performance of the nurse-midwives was compared with that of doctors in a controlled, randomised clinical trial. Some operative difficulty was encountered by the nurses in 4.9% of cases and by the doctors in 2.0% of cases. This difference is not statistically significant and arose largely because the nurse-midwife cases were more obese. Nurse-midwives required a significantly longer operating-time (18.5 min) than doctors (11.9 min). However, postoperative morbidity was similar in the two groups (7.0% and 6.0%, respectively). These results suggest that trained nurse-midwives with theatre experience can safely provide post-partum sterilisation services. A further field trial is underway.
D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D008875:Middle Aged; D009721:Nurse Midwives / Q000193:education; D010820:Physicians; D049590:Postpartum Period; D011247:Pregnancy; D011787:Quality of Health Care; D012423:Rural Health; D013246:Sterilization, Tubal / Q000379:methods / Q000600:supply & distribution*; D013647:Task Performance and Analysis; D013785:Thailand