Reducing neonatal mortality rate with nurse-midwives


69 Butler Street, SE, Atlanta, Georgia 30303.


Newborn health indices were measured before, during, and after a demonstration nurse-midwife program introduced to relieve a health manpower shortage at a county hospital in rural California. During the program, prenatal care increased, and prematurity and neonatal mortality rate decreased at the county hospital. After the 3 year program, prenatal care decreased while prematurity rose from 6.6 to 9.8 per cent (p < 0.02) and neonatal mortality rate rose from 10.3 to 32.1 per 1,000 live births (p < 0.005). No significant changes occurred in the same indices for births elsewhere in the county throughout the period of study. It is concluded that the discontinuation of the nurse-midwives'services was the major factor in these changes, and it is suggested that nurse-midwives be used more extensively.