BACKGROUND No studies have examined the effect of socioeconomic deprivation on antepartum and intrapartum stillbirths in the poorest women in low income countries. METHODOLOGY/ PRINCIPAL FINDINGS This study used data from a prospective population based surveillance system involving all women of childbearing age and their babies in rural Ghana. The primary objective was to evaluate association...

BACKGROUND The Tibetan Delek Hospital is a small general hospital providing primary and secondary care for the Tibetan refugee community and the local Indian population in Dharamsala, Himachal Pradesh, North India. In a baseline clinical audit of intrapartum care at the Tibetan Delek Hospital in 1996, high levels of postpartum haemorrhage associated with poor medical management of the third sta...

For 22 years I delivered babies as a family physician—22 years of wearing a pager 24 hours a day, 7 days a week. It was amazingly invigorating and inspiring, and at times onerous and overwhelming. September is the perfect time to talk about delivering babies—9 months after New Year’s, it is always a busy month in labour and delivery. This is a National Physician Survey (NPS) year, and one of th...

OBJECTIVE To evaluate the reliability of direct observation for measuring intrapartum care and compare this method with clinical audits using objective criteria based on patients' medical charts. DESIGN Cross-sectional study, data collected by two independent evaluators. SETTING Hospital in Dakar, Senegal. PARTICIPANTS Thirty consecutive intrapartum care episodes provided by midwives and ...

OBJECTIVE To examine differences in outcomes between planned home births, occurring at home or in hospital, and planned hospital births. DESIGN AND SETTING Population-based study using South Australian perinatal data on all births and perinatal deaths during the period 1991-2006. Analysis included logistic regression adjusted for predictor variables and standardised perinatal mortality ratios...

OBJECTIVE Collaborative, interdisciplinary care models have the potential to improve maternity care. Differing attitudes of maternity care providers may impede this process. We sought to examine the attitudes of Canadian maternity care practitioners towards labour and birth. METHODS We performed a cross-sectional web- and paper-based survey of 549 obstetricians, 897 family physicians (400 ant...

Intrapartum cardiotocograph (CTG) monitoring is widely used in the provision of maternity care high-income countries. First introduced into clinical practice 1960s, it was anticipated that the use of CTG labour would dramatically reduce the perinatal mortality rate and prevent long term neurological injury, while also reducing caesarean section rate (Paul & Hon, 1970, Obstetrics Gynaecology 35(...

BACKGROUND Each year 700,000 infants die due to intrapartum-related complications. Implementation of Helping Babies Breathe (HBB)-a simplified neonatal resuscitation protocol in low-resource clinical settings has shown to reduce intrapartum stillbirths and first-day neonatal mortality. However, there is a lack of evidence on the effect of different HBB implementation strategies to improve and s...

BACKGROUND Recent studies have shown that the most important risk factors for perinatal mortality in developing countries are not detectable during antenatal care but can be observed only shortly before or during labour. Although 60% of perinatal deaths in these countries are stillbirths, few epidemiological studies focus on them. We tested the hypothesis that the risk factors for late stillbir...

PROBLEM Maternal and neonatal mortality remains high in low- and middle-income countries, with poor quality of intrapartum care as a barrier to further progress. APPROACH We developed and tested a method of measuring the quality of maternal and neonatal care that could be embedded in a larger national performance management initiative. The tool used direct observations and medical record revi...