Document Detail


Maternity care and outcomes in a high-risk service: the North Central Bronx Hospital experience.
MedLine Citation:
PMID:  2006959     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 possible.
Authors:
D B Haire; C C Elsberry
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Birth (Berkeley, Calif.)     Volume:  18     ISSN:  0730-7659     ISO Abbreviation:  Birth     Publication Date:  1991 Mar 
Date Detail:
Created Date:  1991-05-01     Completed Date:  1991-05-01     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8302042     Medline TA:  Birth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  33-7     Citation Subset:  N    
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MeSH Terms
Descriptor/Qualifier:
Delivery, Obstetric / methods,  statistics & numerical data
Female
Humans
Infant Mortality
Infant, Newborn
Medical Indigency*
New York City
Nurse Midwives / standards*
Obstetric Labor Complications / epidemiology
Obstetrics and Gynecology Department, Hospital / organization & administration,  standards*
Organizational Policy
Pregnancy
Pregnancy Outcome*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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