The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #57893

Tourette Antiquenette Jackson, MPH, Oak Ridge Institute for Science and Education (ORISE) Fellow, TRICARE Pacific Lead Agency, 1 Jarrett White Road, Honolulu, HI 95859/5000, 808-433-2813, tourette.jackson@haw.tamc.amedd.army.mil

Childbirth is a natural event that carries the possibility of complications at various magnitudes. In industrialized countries general socioeconomic development coupled with the widespread availability of well-organized maternity services have made the death of a woman or child minimal. However, in developing regions, specifically Pedro Moncayo, Ecuador these characteristics are almost nonexistent. Therefore, many women in these rural areas rely solely on midwives to meet their gynecological and obstetrical needs. During the study period midwives in Pedro Moncayo, Ecuador were facing legislative outlaw. Accusations stated midwives were the primary cause for low birth weight babies and high-risk complications during both pregnancy and delivery. This study uses data from the cross-sectional “Demographics, Offer and Demand of Health Services, Morbidity and Growth Factors Related to Children survey”, developed in the summer of 2001 to assess the community health status of Pedro Moncayo, Ecuador. This study is a secondary data analysis focusing on maternal and child health variables from the preliminary data set. Pearson’s Chi-square Test is used (alpha = .05) to compare proportions from the independent samples to identify the association of midwife attended prenatal care and physician attended prenatal care and the resulting pregnancy outcomes. Pregnancy outcomes are defined as: (1) elective abortion (2) complications during pregnancy and (3) premature birth. Results show there is not a significant difference in pregnancy outcomes via use of midwives at home in comparison to physicians in a clinic setting. The importance for continued use of midwives, and additional training and supplies is considered.

Learning Objectives:

At the end of the presentation, participants should be able to:
• Describe the infrastructure of the Ecuadorian Health Care System.
• Identify the certification and regulation criteria for midwives in Pedro Moncayo, Ecuador.
• Understand the challenges facing midwifery practice in Pedro Moncayo, Ecuador.
• Recognize the importance of midwives in meeting the obstetrical and gynecological needs of communities that lack well organized maternal and child health services

Keywords: Midwifery, Birth Outcomes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.