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Aboriginal and Torres Strait Islander women's health: acting now for a healthy future.

https://arctichealth.org/en/permalink/ahliterature153251
Source
Aust N Z J Obstet Gynaecol. 2008 Dec;48(6):526-8
Publication Type
Article
Date
Dec-2008
Author
Jacqueline Boyle
Alice R Rumbold
Marilyn Clarke
Chris Hughes
Simon Kane
Source
Aust N Z J Obstet Gynaecol. 2008 Dec;48(6):526-8
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Female
Forecasting
Gynecology - standards
Humans
Maternal Age
Obstetrics - standards
Oceanic Ancestry Group
Pregnancy
Risk factors
Rural Health
Socioeconomic Factors
Women's Health - legislation & jurisprudence
Abstract
This paper summarises the recent RANZCOG Indigenous Women's Health Meeting with recommendations on how the College and its membership can act now to improve the health of Aboriginal and Torres Strait Islander women and infants.
PubMed ID
19133037 View in PubMed
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An evaluation by the Norwegian Health Care Supervision Authorities of events involving death or injuries in maternity care.

https://arctichealth.org/en/permalink/ahliterature299007
Source
Acta Obstet Gynecol Scand. 2018 Oct; 97(10):1206-1211
Publication Type
Journal Article
Date
Oct-2018
Author
Lars Thomas Johansen
Geir Sverre Braut
Jan Fredrik Andresen
Pål Øian
Author Affiliation
Norwegian Board of Health Supervision, Oslo, Norway.
Source
Acta Obstet Gynecol Scand. 2018 Oct; 97(10):1206-1211
Date
Oct-2018
Language
English
Publication Type
Journal Article
Keywords
Birth Injuries - epidemiology - mortality
Clinical Competence
Female
Fetal Monitoring - standards
Humans
Infant
Infant mortality
Infant, Newborn
Interprofessional Relations
Malpractice - statistics & numerical data
Medical Errors - mortality - statistics & numerical data
Norway
Obstetrics - standards
Obstetrics and Gynecology Department, Hospital - standards
Pregnancy
Professional Role
Abstract
We aimed to determine how serious adverse events in obstetrics were assessed by supervision authorities.
We selected cases investigated by supervision authorities during 2009-2013. We analyzed information about who reported the event, the outcomes of the mother and infant, and whether events resulted from errors at the individual or system level. We also assessed whether the injuries could have been avoided.
During the study period, there were 303 034 births in Norway, and supervision authorities investigated 338 adverse events in obstetric care. Of these, we studied 207 cases that involved a serious outcome for mother or infant. Five mothers (2.4%) and 88 infants (42.5%) died. Of the 207 events reported to the supervision authorities, patients or relatives reported 65.2%, hospitals reported 39.1%, and others reported 4.3%. In 8.7% of cases, events were reported by more than 1 source. The supervision authority assessments showed that 48.3% of the reported cases involved serious errors in the provision of health care, and a system error was the most common cause. We found that supervision authorities investigated significantly more events in small and medium-sized maternity units than in large units. Eighteen health personnel received reactions; 15 were given a warning, and 3 had their authority limited. We determined that 45.9% of the events were avoidable.
The supervision authorities investigated 1 in 1000 births, mainly in response to complaints issued from patients or relatives. System errors were the most common cause of deficiencies in maternity care.
PubMed ID
29806955 View in PubMed
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Are stipulated requirements for the quality of maternity care complied with?

https://arctichealth.org/en/permalink/ahliterature287789
Source
Tidsskr Nor Laegeforen. 2017 09 19;137(17)
Publication Type
Article
Date
09-19-2017
Author
Lars T Johansen
Aase Serine Devold Pay
Lise Broen
Brit Roland
Pål Øian
Source
Tidsskr Nor Laegeforen. 2017 09 19;137(17)
Date
09-19-2017
Language
English
Norwegian
Publication Type
Article
Keywords
Birthing Centers - manpower - organization & administration - standards
Clinical Competence
Delivery Rooms - manpower - organization & administration - standards
Delivery, Obstetric - standards
Female
Fetal Monitoring - standards
Guideline Adherence
Hospitals - manpower - standards
Hospitals, Maternity - manpower - organization & administration - standards
Humans
Midwifery - manpower
Norway
Obstetrics and Gynecology Department, Hospital - manpower - organization & administration - standards
Patient Selection
Personnel Staffing and Scheduling - standards
Physicians
Pregnancy
Quality of Health Care - standards
Risk assessment
Staff Development
Surveys and Questionnaires
Abstract
The Directorate of Health’s national guide Et trygt fødetilbud – kvalitetskrav til fødselsomsorgen [A safe maternity service – requirements regarding the quality of maternity care] was published in December 2010 and was intended to provide a basis for an improved and more predictable maternity service. This article presents data from the maternity institutions on compliance with the quality requirements, including information on selection, fetal monitoring, organisation, staffing and competencies.
The information was acquired with the aid of an electronic questionnaire in the period January–May 2015. The form was sent by e-mail to the medical officer in charge at all maternity units in Norway as at 1 January 2015 (n=47).
There was a 100?% response to the questionnaire. The criteria for selecting where pregnant women should give birth were stated to be in conformity with the quality requirements. Some maternity institutions failed to describe the areas of responsibilities of doctors and midwives (38.5?% and 15.4?%, respectively). Few institutions recorded whether the midwife was present with the patient during the active phase. Half of the maternity departments (level 2 birth units) reported unfilled doctors’ posts, and a third of the university hospitals/central hospitals (level 1 birth units) reported a severe shortage of locum midwives. Half of the level 2 birth units believed that the quality requirements had resulted in improved training, but reported only a limited degree of interdisciplinary or mandatory instruction.
The study reveals that there are several areas in which the health enterprises have procedures that conform to national quality requirements, but where it is still unclear whether they are observed in practice. Areas for improvement relate to routines describing areas of responsibility, availability of personnel resources and staff training.
PubMed ID
28925199 View in PubMed
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[Are there any regional differences when it comes to obstetrical care quality?]

https://arctichealth.org/en/permalink/ahliterature58218
Source
Lakartidningen. 2004 Nov 4;101(45):3615; discussion 3616
Publication Type
Article
Date
Nov-4-2004

Assessing quality of obstetric care for low-risk deliveries; methodological problems in the use of population based mortality data.

https://arctichealth.org/en/permalink/ahliterature58752
Source
Acta Obstet Gynecol Scand. 2000 Jun;79(6):478-84
Publication Type
Article
Date
Jun-2000
Author
D. Moster
T. Markestad
R T Lie
Author Affiliation
Medical Birth Registry of Norway, Locus of Registry-based Epidemiology, University of Bergen, Department of Pediatrics, Haukeland University Hospital.
Source
Acta Obstet Gynecol Scand. 2000 Jun;79(6):478-84
Date
Jun-2000
Language
English
Publication Type
Article
Keywords
Adult
Bias (epidemiology)
Delivery, Obstetric
Female
Fetal Death
Humans
Infant, Newborn
Middle Aged
Norway - epidemiology
Obstetrics - standards
Population Surveillance
Pregnancy
Quality of Health Care
Registries
Research Support, Non-U.S. Gov't
Risk factors
Sample Size
Sensitivity and specificity
Abstract
BACKGROUND: Studies evaluating safety of different birth settings for low-risk deliveries are often difficult to interpret because of great methodological problems. OBJECTIVE: To assess potential bias in comparisons of mortality between maternity institutions with different size and level of care, particularly when using various definitions of low-risk delivery and when studying stillbirth rates. DESIGN: Population-based study. POPULATION: The population of 1.74 million births in Norway from 1967 to 1996 recorded in The Medical Birth Registry of Norway. METHODS: First we explored the problems of properly identifying low-risk deliveries from population-based data and calculated adjusted perinatal mortality rates in sub-populations by excluding different risk factors. Then we measured the difference in apparent low-risk deliveries between institutions of different size and level of care. Finally we explored bias by using stillbirths and discuss the loss of statistical power by studying only livebirths. RESULTS: The occurrence of a whole spectrum of risk factors differed between small and large institutions, even after adjustment for birthweight. Although the majority of births were from low-risk deliveries, only 1/10th of all perinatal deaths occurred in this group after admission to a maternity unit. There was a systematic difference in the reporting of time of death for stillbirths between types of institutions; the rate of stillbirths occurring during delivery was higher among small institutions, while large institutions were more often uncertain in classifying time of death for stillbirths. CONCLUSIONS: Adjustments for a large number of different risk factors, large sample-sizes and caution in including stillbirth as outcome measure are needed when comparisons of safety between different sizes of delivery units are made for low-risk pregnancies.
PubMed ID
10857872 View in PubMed
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Attitudes among Toronto obstetricians towards vaginal breech delivery.

https://arctichealth.org/en/permalink/ahliterature133979
Source
J Obstet Gynaecol Can. 2011 May;33(5):437-42
Publication Type
Article
Date
May-2011
Author
Karthika Devarajan
P Gareth Seaward
Dan Farine
Author Affiliation
Department of Obstetrics and Gynaecology, University of Toronto, Ontario.
Source
J Obstet Gynaecol Can. 2011 May;33(5):437-42
Date
May-2011
Language
English
Publication Type
Article
Keywords
Breech Presentation
Delivery, Obstetric - standards
Female
Health Knowledge, Attitudes, Practice
Health Surveys
Hospitals, Teaching
Humans
Obstetrics - standards
Ontario
Practice Guidelines as Topic
Pregnancy
Pregnancy Complications
Questionnaires
Abstract
The recent SOGC guidelines allow for selective vaginal delivery of breech presentations, following an eight-year period during which vaginal breech delivery was discouraged based on the results of the Term Breech Trial (TBT). We sought to determine the effect of publication of this guideline on the acceptance of vaginal breech delivery by obstetricians and to correlate obstetricians' attitudes with actual practice.
A survey was sent to all obstetricians practising in five teaching hospitals in Toronto exploring their attitudes towards, and comfort with, vaginal breech delivery in various clinical situations. We correlated these with their graduation year in relation to the publication of the TBT. We also reviewed the obstetrical database of the largest teaching hospital in Toronto to see if these attitudes correlated with actual practice.
The vaginal breech delivery rate, which was declining prior to publication of the TBT, plummeted after it. Our survey found that most practitioners (50% to 80%) would be willing to provide vaginal breech delivery in defined conditions, with more experienced obstetricians being more comfortable with offering vaginal breech delivery. However, despite these attitudes, the vaginal breech delivery rate during the period surveyed was only 3% (6/195).
In the eight years between publication of the TBT and the new guidelines, very few vaginal breech deliveries were performed. Our survey indicates that most obstetricians have accepted the new guidelines; however, it seems that actual practice is lagging behind. The recent SOGC guidelines seem to have changed attitudes, but without changes in training and practical support, it seems unlikely that the trend for very few vaginal breech deliveries to be performed will be reversed.
PubMed ID
21639962 View in PubMed
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Source
Ugeskr Laeger. 2003 Nov 17;165(47):4513-5
Publication Type
Article
Date
Nov-17-2003
Author
Birgit Bødker
Author Affiliation
Gynaekologisk-obstetrisk Afdeling, Hillerød Sygehus, DK-3400 Hillerød.
Source
Ugeskr Laeger. 2003 Nov 17;165(47):4513-5
Date
Nov-17-2003
Language
Danish
Publication Type
Article
Keywords
Denmark
Female
Humans
Medical Audit
Obstetrics - standards
Pregnancy
PubMed ID
14677225 View in PubMed
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Birth outcomes by level of obstetric care in Finland: a catchment area based analysis.

https://arctichealth.org/en/permalink/ahliterature217647
Source
J Epidemiol Community Health. 1994 Aug;48(4):400-5
Publication Type
Article
Date
Aug-1994
Author
K. Viisainen
M. Gissler
E. Hemminki
Author Affiliation
Department of Public Health University of Helsinki, Finland.
Source
J Epidemiol Community Health. 1994 Aug;48(4):400-5
Date
Aug-1994
Language
English
Publication Type
Article
Keywords
Catchment Area (Health)
Cross-Sectional Studies
Delivery, Obstetric - standards
Female
Finland - epidemiology
Hospitals, Maternity - standards
Humans
Infant mortality
Infant, Low Birth Weight
Infant, Newborn
Obstetrics - standards
Pregnancy
Pregnancy outcome
Reproductive history
Risk factors
Abstract
To study whether hospitals of different levels are equally safe places to give birth in a regionalised system of care.
This was a population based, cross sectional survey comparing birth outcomes in nationwide catchment areas of different levels of hospital care. All women and low risk women were examined separately.
The study population comprised all women who gave birth in Finland in 1987-88. The data were obtained from the Finnish Medical Registry, complemented by official data.
No statistically significant differences were found in crude or birthweight specific perinatal mortality rates between the catchment areas, nor did the other outcomes studied favour tertiary care compared with other levels of care in the area based analysis.
In a regionalised system of birth care with a proper referral system, small local hospitals are as safe places to give birth as tertiary care hospitals.
Notes
Cites: N Engl J Med. 1982 Jul 15;307(3):149-557088051
Cites: J Epidemiol Community Health. 1993 Jun;47(3):242-78350040
Cites: Am J Obstet Gynecol. 1985 Jul 1;152(5):517-244014345
Cites: Scand J Soc Med. 1985;13(3):113-84040649
Cites: Lancet. 1985 Aug 24;2(8452):429-322863454
Cites: Acta Paediatr Scand. 1986 Jan;75(1):10-63953264
Cites: Br J Obstet Gynaecol. 1986 Jul;93(7):675-833524667
Cites: Br J Obstet Gynaecol. 1986 Jul;93(7):690-33730338
Cites: J Rural Health. 1988 Jul;4(2):101-1710288967
Cites: Community Health Stud. 1988;12(4):386-933243073
Cites: Am J Obstet Gynecol. 1989 Jul;161(1):86-912750825
Cites: Int J Health Serv. 1990;20(2):221-322332261
Cites: J Nurse Midwifery. 1991 Nov-Dec;36(6):327-331757818
Cites: Qual Assur Health Care. 1992 Jun;4(2):133-91511147
Cites: Int J Epidemiol. 1992 Aug;21(4):720-41521976
Cites: Med Care. 1983 Dec;21(12):1131-436656337
PubMed ID
7964341 View in PubMed
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[Birth statistics for "standard populations". A basis for obstetric quality development]

https://arctichealth.org/en/permalink/ahliterature64456
Source
Ugeskr Laeger. 1996 Jul 29;158(31):4385-9
Publication Type
Article
Date
Jul-29-1996
Author
J. Langhoff-Roos
A O Agger
J. Lyndrup
C. Wilken-Jensen
L. Kure
Author Affiliation
DSI-Institut for Sundhedsvaesen, Kobenhavn.
Source
Ugeskr Laeger. 1996 Jul 29;158(31):4385-9
Date
Jul-29-1996
Language
Danish
Publication Type
Article
Keywords
Adult
Birth rate
Delivery, Obstetric
Denmark - epidemiology
English Abstract
Female
Humans
Labor Presentation
Obstetrics - standards
Parity
Pregnancy
Quality Assurance, Health Care
Registries
Abstract
Using standard populations like "standard-primipara" (normal pregnancy, singleton term delivery and cephalic presentation) and "caesarean secundapara" (previous caesarean section and second birth) as the basis for interunit comparisons of maternity care will control for differences in casemix that may be seen at different units, thereby increasing the validity of comparisons. Focusing on clinically meaningful subsets of the population may have the additional benefit of clarifying the relationship between everyday clinical decision making, and the statistics from medical birth registration. Birth registry data from Rigshospitalet, Hvidovre Hospital and Herning Centralsygehus 1993-1994 have been used to illustrate the association between local quality improvement activities, on the one hand, and rates of interventions and foetal outcome in "standard-primipara" on the other.
PubMed ID
8759994 View in PubMed
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Childbirth customs in Orthodox Jewish traditions.

https://arctichealth.org/en/permalink/ahliterature202572
Source
Can Fam Physician. 1999 Mar;45:682-6
Publication Type
Article
Date
Mar-1999
Author
K. Bodo
N. Gibson
Author Affiliation
Department of Public Health Sciences and Family Medicine, University of Alberta, Edmonton.
Source
Can Fam Physician. 1999 Mar;45:682-6
Date
Mar-1999
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cultural Characteristics
Female
Humans
Judaism
Labor, Obstetric - psychology
Obstetrics - standards
Physician-Patient Relations
Pregnancy
Prenatal Care
Abstract
To describe cultural beliefs of Orthodox Jewish families regarding childbirth in order to help family physicians enhance the quality and sensitivity of their care.
These findings were based on a review of the literature searched in MEDLINE (1966 to present), HEALTHSTAR (1975 to present), EMBASE (1988 to present), and Social Science Abstracts (1984 to present). Interviews with several members of the Orthodox Jewish community in Edmonton, Alta, and Vancouver, BC, were conducted to determine the accuracy of the information presented and the relevance of the paper to the current state of health care delivery from the recipients' point of view.
Customs and practices surrounding childbirth in the Orthodox Jewish tradition differ in several practical respects from expectations and practices within the Canadian health care system. The information presented was deemed relevant and accurate by those interviewed, and the subject matter was considered to be important for improving communication between patients and physicians. Improved communication and recognition of these differences can improve the quality of health care provided to these patients.
Misunderstandings rooted in different cultural views of childbirth and the events surrounding it can adversely affect health care provided to women in the Orthodox Jewish community in Canada. A basic understanding of the cultural foundations of potential misunderstandings will help Canadian physicians provide effective health care to Orthodox Jewish women.
Notes
Cites: Eur J Obstet Gynecol Reprod Biol. 1997 Feb;71(2):113-219138953
Cites: J Obstet Gynecol Neonatal Nurs. 1995 May;24(4):327-317643264
Cites: J Nurse Midwifery. 1980 Sep-Oct;25(5):39-426902767
Cites: Am J Hum Genet. 1993 Dec;53(6):1359-658250053
Cites: CMAJ. 1992 Jan 1;146(1):29-331728349
Cites: Mod Midwife. 1994 Sep;4(9):11-47953810
PubMed ID
10099807 View in PubMed
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70 records – page 1 of 7.