摘要:

ABSTRACT:The 25 years of rising cesarean delivery rates in the United States may have finally run their course. In 1989 the rate of 23.8 cesareans per 100 deliveries was not significantly different from 24.7 in 1988, 24.4 in 1987, or 24.1 in 1986. The 1989 primary rate of 17.1 first cesareans per 100 women with no previous cesarean was also not significantly different from 17.5 for 1988, or 17.4 for 1987 and 1986. The percentage of vaginal births after cesarean section per 100 deliveries showed a remarkable rise between 1988 and 1989—from 12.6 percent in 1988 to 18.5 percent in 1989. Data are from the National Hospital Discharge Survey conducted by the National Center for Health Statistics, Centers for Disease Contro

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00063.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT:This case‐control investigation examined the relationship between absence of specific educational content during prenatal care and risk of adverse birth outcomes. A total of 1484 women from three regions with high rates of low birthweight and infant mortality participated in structured postpartum interviews. Analyses were performed for both the full sample and three regional subsamples. For the full sample an adjusted risk ratio of 2.87 (95% CI = 1.75, 4.71) was noted between risk of preterm low birthweight and lack of advice to call the health provider if preterm labor were suspected. For one subsample an adjusted risk ratio of 2.50 (95% CI = 1.11, 5.60) was noted between the risk of preterm low birthweight and lack of education on the signs and symptoms of preterm labor. This study reinforces a body of literature that stresses the importance of appropriate prenatal care in preventing preterm low birthweight. It further suggests that adequacy measures of prenatal care should reflect quality and content as well as timing and number of prenatal visit

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00064.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT:The Apgar score has been useful for nearly four decades in focusing on five physiological signs (heart rate, respiratory effort, reflex irritability, muscle tone, color) that denote the condition of an infant during the first critical minutes of life. Before the development of the system, narcotic analgesia and sedation during labor, and general anesthesia for vaginal deliveries were commonly used. Research of the scoring method has focused on the effects of these interventions on the fetus and newborn and has been a major impetus for change in obstetric practices. The Apgar score has been used as a predictive index for neonatal mortality and morbidity and for later neurologic or developmental disability. Both the one‐ and five‐minute scores are predictors of mortality in normal‐birthweight infants, whereas in high‐risk low‐birthweight infants their score is limited. The score is an insensitive predictive index of long‐term neurologic or mental handicap, and lacks both sensitivity and specificity to reflect accurately the degree of acidosis. It can be used effectively, however, if these limitations are understood and

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00065.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT:For the past four years, grassroots organizing efforts in Rhode Island have been directed toward improving maternal and infant health. Coalitions of consumer organizations, health care providers, and activists have achieved important legislative initiatives, such as health insurance for uninsured pregnant women and promotion of midwifery services. This article examines the processes involved in organizing for improved maternal and infant health care, the dynamics involved in achieving a particular outcome, and the ways in which grassroots mobilization can affect public policy and contribute toward improved maternal and infant health.

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00066.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00067.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT:Midwives in Ontario, Canada, currently have no legal status. After an announcement in 1986 that the government would recognize them, an extensive planning period ensued. Groups of health care providers, consumers, and government representatives were active participants in formulating plans to integrate midwives into the centrally organized health care system in Ontario. Efforts to introduce legislation, establish a regulatory framework, and develop an educational program are well developed, but legalized practice must yet be realized.

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00068.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00069.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT:An estimated 9202 drug‐exposed infants were born in the United States in 1986 according to the National Center for Health Statistics; the number increased to 13,765 in 1988. These figures were substantially underreported, however, notes the 1990 report by the U.S. General Accounting Office (GAO) (1). It surveyed 10 hospitals, two each in Boston, Chicago, Los Angeles, New York, and San Antonio, accounting for 44,655 births, of which approximately 4000 resulted in drug‐exposed infants in 1989. Maternal cocaine use was estimated to range from below 1 to 12 percent among the 10 hospitals. The GAO report concluded that the number of these infants born nationwide each year could be “very high,” and that in these five cities the unavailability of drug treatment and lack of adequate prenatal care are contributing to the problem (1). Two health professionals and a health lawyer were invited to respond to some questions about the problems of cocaine and substance abuse by pregnant women and how maternity caregivers, health and social service agencies, law, and society are dealing with the

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00070.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00071.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00072.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY