comparison of deliveries at a hospital versus a maternal and child health centre

ABSTRACT

The present study compared between 123 women delivered at a maternal and child health centre with 500 women delivered at a maternity hospital. Results revealed some significant differences between the 2 groups, including a higher level of education among the MCHC cases and their husbands, and a higher mean score for the hospital cases on the 6 scales of the Middlesex Hospital questionnaire that identifies 6 different psychoneurotic states. Use of antenatal care was judged as inadequte for the greater proportion of both groups, but the proportion that did not receive any care was much higher among hospital cases. Women tended to use the same setting, and often the same facility for delivery; the majority of those who delivered at the hospital not having utilized the MCHC for antenatal or delivery care. Concerning medical and obstetric differences, based on the Hobel et al.,[1973] scoring system it appeared that the proportion of high risk cases was significantly higher among the hospital group; the number of risk factors identified and their incidence being greater among that group. Regarding obstetric intereferences, it appeared that the process of childbirth was allowed to proceed naturally at the MCHC, whereas different types of interferences were recorded for the low risk group delivered at the hospital. Assessing the performance of the MCHC as a setting for maternity care was approached by examining the process of screening and selection of cases, the outcome of delivery, and the consumers' attitude towards the service. It appeared that the compliance rate with the centre's screening criteria was very high, but based on the Hobel et al., [1973] criteria 14.6% of cases should not have been accepted for delivery. Concerning outcome of care no other complication but one incident of postpartum hemorrhage was recorded for the MCHC cases, denoting the safety of this service. The majority of women who delivered at the MCHC favoured the centre over the hospital when their opinion was sought regarding 4 different aspects of the service