Reducing neonatal mortality rate with nurse-midwives.
Newborn health indices were measured before, during, and after a demonstration nurse-midwife program introduced to relieve a health manpower shortage at a county hospital in rural California. During the program, prenatal care increased, and prematurity and neonatal mortality rate decreased at the county hospital. After the 3 year program, prenatal care decreased while prematurity rose from 6.6 to 9.8 per cent (p<0.02) and neonatal mortality rate rose from 10.3 to 32.1 per 1,000 live births (p<0.005). No significant changes occurred in the same indices for births elsewhere in the county throughout the period of the study. It is concluded that the discontinuation of the nurse-midwives' services was the major factor in these changes, and it is suggested that nurse-midwives be used more extensively.
Levy
Barry S
BS
Epidemiology Research Training Program, California State Department of Public Health, Berkely, California, USA.
Wilkinson
Frederick S
FS
Marine
William M
WM
D002140:California; D005313:Fetal Death / Q000517:prevention & control*; D006766:Hospitals, County; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007234:Infant, Premature; D009721:Nurse Midwives / Q000706:statistics & numerical data*; D011295:Prenatal Care; D012424:Rural Population