BACKGROUND Perinatal audit and the three-delays model are increasingly being employed to analyse barriers to perinatal health, at both community and facility level. Using these approaches, our aim was to assess factors that could contribute to perinatal mortality and potentially avoidable deaths at Rwandan hospitals. METHODS Perinatal audits were carried out at two main urban hospitals, one a...

OBJECTIVE To compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low-risk women who started their labour in primary care. DESIGN A nationwide cohort study. SETTING The entire Netherlands. POPULATION A total of 529,688 low-risk women who were in primary midwife-led care at the onset of labour. Of these, 321,307 (60.7%) intended...

AIM To share information on the organization of perinatal care in Portugal. METHODS Data were derived from the Programme of the National Committee for Mother and Child Health 1989, National Institute for Statistics, and Eurostat. RESULTS In 1989, perinatal care in Portugal was reformed: the closure was proposed of maternity units with less than 1500 deliveries per year; hospitals were class...

OBJECTIVE To compare incidences of perinatal mortality and severe perinatal morbidity between low risk term pregnancies supervised in primary care by a midwife and high risk pregnancies supervised in secondary care by an obstetrician. DESIGN Prospective cohort study using aggregated data from a national perinatal register. SETTING Catchment area of the neonatal intensive care unit (NICU) of...

BACKGROUND In several developing countries, achieving Millennium Development Goal 4 is still off track. Multiple maternal and fetal risk factors were inconsistently attributed to the high perinatal mortality in developing countries. However, there was no meta-analysis that assessed the pooled effect of these factors on perinatal mortality. The purpose of this meta-analysis was to identify mater...

BACKGROUND A community-based randomized control prenatal care trial was performed in a rural county of China during 2000-2003. The purpose of this paper is to describe the trial implementation and the impact of the trial on the utilization of prenatal care and perinatal outcomes. MATERIALS AND METHODS In the study county, 10 townships (from a total of 55) were each paired with a control (20 s...

OBJECTIVE Despite dramatic reductions in perinatal human immunodeficiency virus (HIV) transmission in the United States, obstacles to perinatal HIV prevention that include lack of prenatal care; failure to test pregnant women for HIV before delivery; and lack of prenatal, intrapartum, or neonatal antiretroviral (ARV) use remain. The objective of this study was to describe trends in perinatal HI...

OBJECTIVE To describe our experience of a complex training intervention to introduce effective perinatal care, evidence-based medicine, national confidential enquiries into maternal deaths, and facility-based near-miss case reviews in the Central Asian Republics. METHODS We describe our experiences from training sessions and report on findings from data extraction from patient records, patien...

Background & aim: Perinatal mental health problems have been demonstrated to impact upon maternal, and fetal/child outcomes. Despite the global evidence and a policy-driven responsibility for identification of these problems, research demonstrates that student midwives/midwives lack knowledge and confidence to assess, identify, and manage them. A similar context is evident for learning disabili...