The role of advanced training in family planning and reproductive health in a low-income country; the experience of Ethiopia.

Low- and middle-income countries continue to experience high fertility rates and unsafe abortion. Increased access to safe abortion services and family planning are cost-effective ways to reduce maternal morbidity and mortality. With a vision of improving the reproductive health workforce of the country, St. Paul's Hospital Millennium Medical College, in partnership with a university in the United States (U.S.), launched the first family planning and reproductive health fellowship program in Ethiopia. As the premier program in the country, the fellowship has introduced several new initiatives and skills to the existing reproductive health care training options. This program is a stirring example of successful collaboration between a U.S. university and a college in a low- or middle-income country. We have summarized the process of establishing the fellowship program as the first experience in Ethiopia and East Africa.

Vaginal delivery following previous cesarean section in 1983.

In 1983 the question whether or not to perform vaginal delivery following previous cesarean section is again presented to the obstetrical community. Data are presented on 778 patients managed during the decade January 1, 1973 to December 31, 1982. Four hundred seventy-six had scheduled repeat cesarean section on an elective basis. One hundred sixty-five experienced normal vaginal delivery. One hundred thirty-seven failed the attempt and were delivered by cesarean section. The group that delivered vaginally and scheduled elective cesarean section did well. However, in the failed attempt the problems were awesome regardless of indication or number of previous cesarean sections.