ABSTRACT
PIP: 25 nurse midwives with at least 12 years of schooling, 3 1/2 years of training in nursing and midwifery, and a minimum of 1 year of operating room experience were selected from 18 provincial hospitals in Thailand for training in tubal ligations. During the 12 week course in a maternal and child health center in northeastern Thailand, the nurses received preliminary training and assisted surgeons with 3-5 operations; if their performance was approved, they performed 20 operations under a doctor's supervision. All completed the training and returned to be primarily responsible for postpartum sterilizations at their hospitals under the supervision of a gynecologist. Informed volunteer subjects, apparently healthy women having vaginal deliveries who had requested sterilization before delivery, were screened before the operations. The nurse midwives successfully performed 3549 postpartum tubal ligations in the 1st 12 months. The mean age of the sterilization acceptors was 28.2 years and the mean number of living children was 3.6. Assistance was needed from supervising doctors in 18 cases. After 12 months the average operation time was 14.8 plus or minus .3 minutes. The postoperative complications were similar to those in a pilot study, except that mild pyrexia was more common, occurring in 9.1% of cases. 97.4% expressed complete satisfaction on discharge from the hospital. At 6 weeks postpartum 28 of the 1746 cases returning for checkups had minor local complaints. Attitudes of the doctors at the participating hospitals were generally favorable.^ieng
