In 1978, Arizona began licensing lay midwives under regulations designed to maintain adequate standards of care for women desiring a home birth. During four years of this program, 3 per cent of home birth clients were hospitalized for complications and another 15 per cent received postnatal outpatient
The declining length of postpartum stay in hospitals has made it more difficult for staff to provide the kind of care recommended in the nursing literature. This study examines the association between satisfaction with care and three clinical procedures-parent-infant bonding, reconstructing birth events and instruction in care of self and baby.Data taken from an Arizona statewide survey of women who recently gave birth indicated little dissatisfaction with care. However, contingency table analysis revealed that level of satisfaction is associated with the provision of opportunities for parent-infant bonding, review of birthing experience and instruction in care of mother and newborn. Strategies for increasing level of satisfaction are discussed. (Birth Fam J 8:3, Fall 1981) In the last 50 years postpartum care in the United States has undergone a radical change. Before World War I1 women spent 10 days in a hospital bed following a vaginal delivery. After the War the average stay decreased to about six days. While a shorter stay was desired by many women, it also was necessitated by a critical shortage of beds during the postwar "baby boom." Currently most hospitals offer package plans incorporating a 24-to 48hour postpartum stay and some hospitals discharge low-risk women and newborns within two to 12 hours.
Drawing upon a statewide consumer survey conducted in 1979 by the Bureau of Maternal and Child Health, this report focuses on the health service utilization and evaluation of 110 American Indians. The data shows that Indians, in contrast to Anglos, have less prenatal care, a higher incidence of transport to special care facilities, a higher incidence of newborn problems, and unusually high rates of early and late discharge. The Indian women also reported a higher incidence of communication problems with their caretakers and were less satisfied with the care that they received. The discussion considers the problems of less continuity of care and personnel shortages as well as cultural differences for delivering the quality of care mandated by treaty and subsequent laws to this impoverished minority group.
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