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[Changes in Norwegian obstetric practices, 1915-1961].
1Kvinneklinikken, Haukeland Universitetssykehus, 5021 Bergen. per.e.bordahl@helse-bergen.no
Summary
Obstetric interventions like forceps and cesarean sections were common in Oslo from 1915-1961, with rates higher than expected. While maternal mortality decreased, birth traumas and neonatal deaths remained a concern.
Area of Science:
- Obstetrics and Gynecology
- Medical History
- Public Health
Background:
- Limited historical data exists on Norwegian obstetric practices prior to the 1967 Medical Birth Registry.
- Annual reports from Oslo's Maternity Clinic (1915-1961) offer insights into historical obstetric care.
Observation:
- Operative delivery rates varied, with forceps used in 6.5-12.5% of cephalic presentations.
- Cesarean section rates rose from 1.5% in the late 1930s to 6.3% by 1961.
- The vacuum extractor was introduced in 1960.
Findings:
- Maternal mortality declined significantly from 6.4 per thousand (1915-1934) to 0.6 per thousand (1956-1961).
- Eclampsia and preeclampsia accounted for over a third of maternal deaths.
- Operative delivery rates peaked at 14-16% between 1944-1955, then decreased to around 12% by 1960.
Implications:
- High rates of operative interventions may have contributed to birth trauma and neonatal mortality, despite improved maternal survival.
- Cesarean section rates increased sharply during World War II, coinciding with a rise in deliveries.
- Historical data highlights the evolving landscape of obstetric interventions and their associated risks and benefits.