An evaluation of perinatal care practices in Iowa community hospitals is presented. Seventy-two hospitals were visited by a University-based perinatal care team. After an initial assessment, educational programs aimed at correcting deficient care practices were carried out in the community hospitals. A review of the data indicates an improvement in the care of the perinatal patient. The authors feel the methodology employed can be utilized in other rural areas to improve basic perinatal care.
We agree with the statement that "A direct follow-up assessment by team members would serve to more clearly document these findings and provide a far more valid comparison," but unfortunately time constraints made this type of a follow-up assessment prohibitive. The period of time required for us to complete a direct assessment would be something in the range of 18 months to two years. For this reason we chose to do the follow-up by a questionnaire, although the limits of this technique are obvious to all.
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