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Reducing neonatal mortality rate with nurse-midwives
Barry S Levy1, Frederick S Wilkinson, William M Marine
1Epidemiology Research Training Program, California State Department of Public Health, Berkely, California, USA.
Journal of Midwifery & Women'S Health
|March 8, 2005
Summary
A nurse-midwife program improved newborn health by increasing prenatal care and reducing prematurity and mortality. Discontinuation of services reversed these positive newborn health outcomes.
Area of Science:
- Maternal and Child Health
- Nursing
- Public Health
Background:
- Rural hospitals often face healthcare workforce shortages.
- Nurse-midwives can provide essential obstetric and neonatal care.
- Demonstration programs are crucial for evaluating innovative healthcare delivery models.
Purpose of the Study:
- To evaluate the impact of a nurse-midwife program on newborn health indices.
- To assess the effects of nurse-midwife services on prenatal care, prematurity, and neonatal mortality rates.
- To determine the consequences of discontinuing nurse-midwife services.
Main Methods:
- A demonstration nurse-midwife program was implemented in a rural California county hospital.
- Newborn health indicators were tracked before, during, and after the program's 3-year duration.
- Comparative analysis was performed between the hospital and the rest of the county.
Main Results:
- During the program, prenatal care increased, while prematurity and neonatal mortality rates decreased.
- Following program discontinuation, prenatal care declined, and prematurity rose significantly (6.6% to 9.8%).
- Neonatal mortality rates also increased substantially after the program ended (10.3 to 32.1 per 1,000 live births).
Conclusions:
- The nurse-midwives' services were directly linked to improved newborn health outcomes.
- Discontinuation of nurse-midwife services led to a deterioration of newborn health indicators.
- Expanded use of nurse-midwives is recommended to enhance maternal and child health in underserved areas.