ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00043.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.tb00044.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT:Two hundred ninety‐four women were randomly allocated to a group in which the use of a birthing stool (experimental group) or a conventional semirecumbent position (control group) was encouraged. The birthing stool was 32 cm high and allowed the parturient to sit upright and to squat. The husband could sit close behind his wife and support her back. No differences were observed between the two groups regarding mode of delivery, length of the second stage of labor, oxytocin augmentation, perineal trauma, labial lacerations, or vulvar edema. Infant outcome measured by Apgar scores at 1 and 5 minutes postpartum and numbers of neonatal intensive care unit transfers was the same in both groups. Mean estimated blood loss and the number of mothers with a postpartum hemorrhage 600 ml or more were greater in the experimental group than in the control group. Women in the experimental group reported less pain during the second stage of labor, and they and their spouses were more satisfied with the birth position than were parents in the control group. Midwives were less satisfied with their working posture in the experimental grou

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00045.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT:Many women use commercially available home pregnancy tests to determine their pregnancy status before seeking professional health care. Despite the increasing popularity of these products, no national estimates have been reported to date on their frequency of use. We analyzed available data from the 1988 National Maternal and Infant Health Survey to determine the frequency of use of home pregnancy tests during recent pregnancies of women of varying sociodemographic backgrounds. Approximately 33 percent (N= 4700) of the women surveyed used such a device. Use was most frequent among women who were white, married, over age 39 years, highly educated, or had a high family income. We conclude that home pregnancy testing appears to be a frequent procedure, especially among women of high socioeconomic background.

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00046.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT:A retrospective descriptive study of 1001 midwife‐attended home births in Toronto, Ontario, was carried out between January 1983 and July 1988. Interviews with 26 midwives and reviews of client records provided data on maternal age, socio‐economic status, gestation, ruptured membranes, length of labor, episiotomies and perineal lacerations, transfer to hospital of mother or baby or both, infant resuscitation, and breastfeeding. Of 1001 planned home births, 361 involved primiparous women, of whom 245 (68%) remained at home and 116 (32%) required transfer of mother or baby to hospital during labor or the first four postpartum days. Of the 640 multiparous births, 591 (92%) women remained at home and 49 (8%) required transfer to hospital. Among women transferred, 91 had spontaneous vaginal births, 34 had forceps deliveries, and 35 had cesarean sections. Variables significantly associated with maternal transfer for both primiparas and multiparas were length of latent and active phases of the first stage of labor, length of the second stage of labor, and duration of ruptured membranes. Five neonates were transferred and two died, one each after birth at home and in hospital. There were no maternal deaths. The proportion of mothers breastfeeding without supplement at 28 days postpartum was 98.6 perc

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00047.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.tb00048.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT:Linkage of measures of the adequacy, content, and quality of prenatal care with pregnancy outcome is a long‐standing research challenge. We attempted to improve on prior studies by developing a measure of prenatal care that encompasses the specific items thought to mediate its relationship with birthweight and by then examining the association of this measure with birthweight. An eight‐item index of prenatal care was used to abstract information from the medical records of 63 white and 56 black women who gave birth to low‐birthweight (<2500 g) infants and 61 white and 101 black women who gave birth to normal‐weight (3000 + g) infants in 1987 at two Kaiser Permanente facilities. In univariate analyses the mean values for the index were higher in controls than in cases for both black and white women, but the difference was statistically significant only for blacks. In multivariate analysis the index was not significantly associated with the risk of low birthweight for whites or blacks. Prenatal care was extremely homogeneous in this population, which compromised the evaluation of the index as a correlate of low birthweight. We believe that this is a promising method for assessing the content of prenatal care and studying the association between content and outcome

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00049.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT:The 1988 National Maternal and Infant Health Survey was conducted by the National Center for Health Statistics to study factors related to poor pregnancy outcome, such as adequacy of prenatal care; inadequate and excessive weight gain during pregnancy; maternal smoking, drinking, and drug use; and pregnancy and delivery complications. The survey is a nationally representative sample of 11,000 women who had live births, 4000 who had late fetal deaths, and 6000 who had infant deaths in 1988. Mothers were mailed questionnaires based on information from certificates of live birth, reports of fetal death, and certificates of infant death. Information supplied by the mother, prenatal care providers, and hospitals of delivery was linked with the vital records to expand knowledge of maternal and infant health in the United States. Data collection from the Longitudinal Followup of mothers in the survey began in January 1991. It provides information on health and development of low‐ and very low‐birthweight babies, child care and safety, maternal health, maternal depression, and plans for adoption and foster care. Both surveys will provide useful data for clinicians in maternal and child hea

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00050.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

ABSTRACT:The maternity service of the North Central Bronx Hospital, a New York City municipal hospital for the medically indigent, has demonstrated that good maternal and infant outcomes can be obtained in an unselected population of disadvantaged women by using obstetric interventions only when medically indicated. Approximately 70 percent of the mothers cared for in the service are considered at risk or high risk. Of the 3287 deliveries in 1988, 86.1 percent were performed by the midwives on staff. Midwives were the primary providers of prenatal, intrapartum, and postpartum care for all low‐risk mothers, and comanaged with the attending obstetricians the care of all high‐risk mothers. The cesarean section rate was 11.8 percent, and the rate of instrumental delivery was 0.3 percent, with minimal use of oxytocin augmentation (6.4%). Among the 3323 infants delivered in 1988, the last full year before an obstetric residency program was established, the rate of those requiring special or intensive care was 11.1 percent, and neonatal mortality was 9.2 per 1000 live births for all birth weights and 3.7 per 1000 for infants over 1000 g. The experience gained from 10 years and over 25,000 births suggests that the maternity care of both high‐ and low‐risk mothers could be improved by minimizing obstetric intervention whenever p

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1991.tb00051.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.tb00052.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY