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 re duced by midwives providing primary obstetric services. Method: The study w as conducted in;a rural region of the Eastern Cape, South Africa. The prima ry obstetric and final causes of perinatal deaths and avoidable factors rel ated to these deaths were determined in a large town and two small towns. R esults: In the three towns 52 (48.6%) of the 107 avoidable factors were rel ated to medical care while 20 (38.5%) of these had the potential to be prev ented 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 po tential for intervention by midwives. Conclusion: The 22.1% of perinatal de aths potentially preventable by midwives presupposes complete patient coope ration within an optimally functioning health system. (C) 2000 Internationa l Federation of Gynecology and Obstetrics.