Education of women about the prevention of preterm birth.

OBJECTIVES: To describe: 1) The education of pregnant women by health care professionals about the prevention of preterm birth; and 2) professionals' views about future initiatives. BACKGROUND: A population survey of health professionals was conducted in Eastern Ontario. The response rate was 73% (608/835). RESULTS: Education materials for women receiving prenatal care about the prevention of preterm birth were available from 10% (12/115) of family physicians, 40% (23/58) of obstetricians, 19% (57/306) of labour room nurses and 76% (94/124) of the prenatal teachers. Only one third of physicians routinely discussed the signs and symptoms of preterm labour prior to 20 weeks. Practitioners' future priorities were smoking cessation programs for pregnant women and increased attendance at early prenatal classes. CONCLUSIONS: Most women are not being educated by anyone in the health care team about the prevention of preterm birth. There is a need for multidisciplinary guidelines about the timing and type of information for women about risk reduction and the early identification and treatment of preterm labour.

Electronic fetal monitoring: a Canadian survey.

OBJECTIVES: To determine the current status of electronic fetal monitoring (EFM) in Canadian teaching and nonteaching hospitals, to review the medical and nursing standards of practice for EFM and to determine the availability of EFM educational programs. DESIGN: National survey in 1989. PARTICIPANTS: The directors of nursing at the 737 hospitals providing obstetric care were sent a questionnaire and asked to have it completed by the most appropriate staff member. The response rate was 80.5% (593/737); 44 hospitals did not have deliveries in 1988 and were excluded. The remaining hospitals varied in size from 8 to 1800 (mean 162.1) beds and had 1 to 7500 (mean 617.1) births in 1988; 18.8% were teaching hospitals. RESULTS: Of the 549 hospitals 419 (76.3%) reported having at least 1 monitor (range 1 to 30; mean 2.6); the mean number of monitors per hospital was higher in the teaching hospitals than in the nonteaching hospitals (6.2 v. 1.7). Manitoba had the lowest mean number of monitors per hospital (1.1) and Ontario the highest (3.7). In 71.8% of the hospitals with monitors almost all of the obstetric patients were monitored at some point during labour. However, 21.6% of the hospitals with monitors had no policy on EFM practice. The availability of EFM educational programs for physicians and nurses varied according to hospital size, type and region. CONCLUSIONS: Most Canadian hospitals providing obstetric services have electronic fetal monitors and use them frequently. Although substantial research has questioned the benefits of EFM, further definitive research is required. In the meantime, a national committee should be established to develop multidisciplinary guidelines for intrapartum fetal assessment.