The outcome of perinatal care in Inukjuak, Nunavik, Canada 1998-2002.

INTRODUCTION: From the 1950s women in Nunavik were transferred to South Quebec to give birth. Since 1986 women have had the opportunity to give birth in Povungnituk, Nunavik, and the education of community midwives began. Inukjuak, a small community in Nunavik, was included in the project in 1998. There is no possibility for caesarean section or transfer during birth, in any of the places. Women can be transferred in pregnancy or post partum to the small hospital in Povungnituk or to a specialist obstetrical unit in Montreal. STUDY DESIGN: A 5-year retrospective survey of the perinatal care in Inukjuak. METHOD: Data were collected from 1. Birth registrations. 2. Antenatal records in Inukjuak. 3. Records and follow-up of medical evacuations to either Povungnituk or Montreal. RESULTS: Of the 182 women from Inukjuak who gave birth, 72.5% of the women gave birth in their own community. 4.5% women or/and newborn was evacuated for reasons related to birth. The rate of premature birth is 3.3% of all pregnant women from Inukjuak. The PMR is 0.5% of all babies born by women from Inukjuak and 0.7% of all babies born in Inukjuak. CONCLUSION: Three out of four women can stay in Inukjuak and give birth with a PMR of 0.7%

Hungarian midwives and their practice: a national survey.

In 1975 the Hungarian educational system for midwives was shortened from a three year programme to one of ten months duration in order to provide a more immediate supply of midwives in a relatively short period of time, and to reduce the costs associated with midwifery education. Ten years after the educational programme change, a national survey of Hungarian midwives (n = 290) was conducted by the European Regional Office of the World Health Organization and the Hungarian Ministry of Health. This study describes the effects of the two educational programmes and years of practice on Hungarian midwives' self-perception of competency, satisfaction and summative score of responsibility and autonomy. Significantly different group mean scores on variables related to competency and satisfaction were found for the two groups.

Perinatal care in the Soviet Union: a time of transition.

Recent Soviet reforms in health care policy and financing are expected to have a significant impact on perinatal services. Efforts are under way to upgrade the care of pregnant and birthing women. This paper describes some aspects of the current system of perinatal care and prospects for future change.