[Obstetric care in Ytre Nordhordland 1858-87. A comparison with national statistics]

In Ytre Nordhordland, a rural district of western Norway, the number of stillbirths and maternal deaths was 50-60% above the national average. Local unskilled midwives assisted with deliveries, but were of little use in the event of complications. The first educated midwife was appointed in 1860, the second in 1874. In this study, multiple regression analyses were undertaken to examine how educated midwives and obstetric operations influenced maternal mortality and the number of stillbirths during the 30-year period 1858-87. The explained variation was 42% for stillbirths, but only 6% for maternal mortality. While the number of skilled midwives was associated with fewer stillbirths, the opposite was found for obstetric operations, probably because obstetric operations were reserved for the most extreme cases. It is concluded that the local doctors' struggle for appointment of educated midwives was of greater importance than their obstetric skills.