HEPATITIS B: The Nurse-Midwife's Role in Management and Prevention


  • Tyrrel Lou Boehme CNM, MS

    Corresponding author
      College of Nursing, University of Utah, Salt Lake City, UT 84132.
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    • Ms. Boehme obtained her Bachelor of Science Degree at Montana State University in 1968 and her Master's Degree in Maternal Child Health and Nurse-Midwifery at the University of Utah in 1974. Since then, she has combined teaching and private nurse-midwifery practice in addition to employment as a nurse-midwife for the City County Health Department, providing prenatal care for a Southeast Asian refugee population. Currently, she is a research instructor for the University of Utah and a clinician for Planned Parenthood of Utah.

College of Nursing, University of Utah, Salt Lake City, UT 84132.


The hepatitis B carrier rate among the Indochinese refugees in the United States is 12 to 15%. Approximately 30 to 40% of these carriers are highly infectious. A mother who is an infectious carrier has almost a 100% chance of infecting her newborn. In view of this, unless proper precautions are taken, four of every one hundred Southeast Asian newborns will be infected with the Hepatitis B virus. Once infected, the newborn will have an 80 to 90% chance of becoming a carrier. A significant number of these carriers will die of cirrhosis and primary hepatocellular carcinoma as adults. In addition, health care providers are placed at risk when contaminated with the body fluids of carriers. Through an understanding of the serologic markers, a nurse-midwife can identify those prenatal clients who are at risk for transmitting hepatitis B. Once identified, the necessary preventative measures can be taken to interrupt the disease process in the newborn and protect health care personnel.