Maternity and perinatal services in an urban-suburban area

The need for community-wide planning of maternity and newborn services is illustrated by a survey of services in Alameda County, California. The decline in birthrate, coupled with the persistence of a number of low volume obstetrical and newborn units, is reflected in generally underutilized and unevenly distributed services. Primary, intermediate and tertiary levels of care are represented, but not always in a logical relationship to community needs. Postgraduate training in obstetrics and gynecology and in pediatrics continues to produce increasing numbers of specialists despite declining fertility and a decline (represented by children and youth) in the total population.