The potential of midwives providing primary obstetric care to reduce perinatal deaths in a rural region
Objective: To determine the proportion of perinatal deaths that could be reduced by midwives providing primary obstetric services. Method: The study was conducted in a rural region of the Eastern Cape, South Africa. The primary obstetric and final causes of perinatal deaths and avoidable factors related to these deaths were determined in a large town and two small towns. Results: In the three towns 52 (48.6%) of the 107 avoidable factors were related to medical care while 20 (38.5%) of these had the potential to be prevented at the level of care rendered by midwives. In the large town 21 (20.6%) of 102 and in the smaller towns 15 (24.6%) of 61 perinatal deaths had potential for intervention by midwives. Conclusion: The 22.1% of perinatal deaths potentially preventable by midwives presupposes complete patient cooperation within an optimally functioning health system. (C) 2000 International Federation of Gynecology and Obstetrics.