The 131st Annual Meeting (November 15-19, 2003) of APHA |
Patricia E. Bailey, DrPH, Family Health International, PO Box 13950, Research Triangle Park, NC 27709, (919) 544-7040 x 523, pbailey@fhi.org
The purpose of the presentation is to demonstrate the need for renewed attention to assisted vaginal delivery. Recent needs assessments for emergency obstetric care in some countries in Latin America, carried out under the Averting Maternal Death and Disability (AMDD) program, have shown that operative vaginal delivery is rarely performed at any level of health care and is no longer taught in many medical schools. Secondary analysis of CLAP (Centro Latino Americano de Perinatología) data and the MOMA study in Africa as well as the published literature show the wide variation in the use of assisted vaginal delivery. In Latin America cesarean delivery rates have increased rapidly while vaginal operative delivery rates have decreased. Assisted vaginal delivery reduces the morbidity and risks associated with caesarean delivery while reducing the costs of obstetric care. Vacuum extraction can be taught to mid-level practitioners such as midwives, thereby increasing coverage. In addition, assisted vaginal delivery would allow women to give birth closer to home in mid-level facilities when hospitals are not easily accessible or are overcrowded. These are all good reasons to advocate for renewed attention to assisted vaginal delivery in countries where this has been allowed to fade away.
Learning Objectives:
Keywords: Maternal Health, Access and Services
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.