title: Prehospital  maternity care in Norway.
abstract: BACKGROUND
  Out-of-hospital maternity care in Norway is randomly organised and not properly formalized. We wished to examine the extent, organisation and quality of this service.
  
  
  METHODS
  We obtained information from the Norwegian Medical Birth Registry on all unplanned out-of-hospital births in 2008. A questionnaire was sent to all maternity institutions, municipalities and emergency dispatch centres, with questions regarding the practical and formal organisation of the service using figures from 2008.
  
  
  RESULTS
  430 children, all above 22 weeks gestation, were born unplanned outside of hospitals in Norway in 2008. Of these, 194 were born unplanned at home, 189 while being transported and 47 in other locations (doctor's offices, infirmaries, unknown). Five out of 53 maternity institutions (9 %) confirmed they had a formal midwife service agreement for out-of-hospital births. 247 municipalities (79 %) claimed to have no such assistance. Of these, 33 are located at least 90 minutes away from the nearest maternity ward. Half of the emergency dispatch centres had no registration identifying formal agreements on assistance by midwives for out-of-hospital births.
  
  
  CONCLUSIONS
  There is an urgent need to put in place formal agreements between the regional health authorities and the municipalities on out-of-hospital midwife services. A distance of 90 minutes' journey time to a maternity ward to fulfil the right to qualified assistance is not well-founded.
authors.affiliation: Department of Gynaecology and Obstetrics, Stavanger University Hospital, Norway. signe.egenberg@sus.no
authors.forename: Signe
authors.initials: S
authors.lastname: Egenberg
authors.forename: Stein Atle
authors.initials: SA
authors.lastname: Puntervoll
authors.forename: Pål
authors.initials: P
authors.lastname: Øian
mesh_terms: D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D017408:Guidelines as Topic; D006700:Home Childbirth / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D009664:Norway; D009721:Nurse Midwives / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D007744:Obstetric Labor Complications / Q000453:epidemiology; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D018743:Perinatal Care / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D011247:Pregnancy; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014187:Transportation of Patients