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[Changes in Norwegian obstetric practices, 1915-1961].

Per E Børdahl1, Erlend Hem

  • 1Kvinneklinikken, Haukeland Universitetssykehus, 5021 Bergen. per.e.bordahl@helse-bergen.no

Tidsskrift for Den Norske Laegeforening : Tidsskrift for Praktisk Medicin, Ny Raekke
|December 21, 2004
PubMed
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.

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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.

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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.