Postpartum Sterilization by Nurse-Midwives in Thailand

Kanchanasinith, K; Piyapinyo, P; Pitaktepsombati, P; Vibulsresth, Suvathana; Gates, Deborah; Janowitz, Barbara; Robbins, Mark

doi:10.2307/2133469

Cited by 12 publications

(13 citation statements)

References 1 publication

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“…Ten years of experience in the outcome of surgery delegated to assistant medical officers, specifically prepared during three year training courses, indicate that the complications after major obstetric surgery are similar among assistant medical officers and specialists in obstetrics and gynaecology. Experiences from other countries, such as Zaire 3,4 , Thailand 5 and Bangladesh 6 , show similar Results.…”

Section: Discussionsupporting

confidence: 55%

A comparative study of caesarean deliveries by assistant medical officers and obstetricians in Mozambique

Pereira

Bugalho

Bergström

et al. 1996

BJOG

127

103

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Objective To evaluate the outcome of caesarean delivery performed by assistant medical officers and specialists in obstetrics and gynaecology with particular attention to post‐operative complications. Design We performed a nonrandomised analysis of 2071 consecutive caesarean deliveries at Maputo Central Hospital. Of these, 958 (46.3%) were performed by assistant medical officers (medical assistants trained for surgery) and the rest (53.7%) by specialists in obstetrics and gynaecology. The age and parity distributions of women in the two groups were almost identical. Setting University Hospital in Maputo, covering all emergency obstetrics with about 48,000 deliveries per year. Population Two thousand and seventy‐one consecutive caesarean deliveries. Main outcome measures Post‐operative complications and the duration of post‐operative hospital stay. Results There were no differences in the indications for caesarean delivery. The surgical interventions associated with caesarean delivery did not differ in the two groups. The only significant difference was in the group of superficial wound separation due to haematoma, which was slightly more common (0.35%vs 0.05%) in the group operated on by assistant medical officers (Odds Ratio 2.2; 95% Confidence Interval 1.3–3.9) Conclusion Training selected medical assistants to perform caesarean delivery, even on women in poor general condition, is justified in settings in which doctors are scarce.

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Section: Discussionsupporting

confidence: 55%

A comparative study of caesarean deliveries by assistant medical officers and obstetricians in Mozambique

Pereira

Bugalho

Bergström

et al. 1996

BJOG

127

103

View full text Add to dashboard Cite

show abstract

“…Studies also showed that these paramedical personnel, in general, provided more thorough counseling to the patients [96], and that their service was also found to be acceptable to patients and the medical profession in Thailand. Other LDCs where the demand for PuTS is similarly high, but obstetricians/gynecologists are in short supply, should consider this alternative service delivery approach.…”

Section: Paramedical Personnel As Operatorsmentioning

confidence: 98%

A review of safety, efficacy, pros and cons, and issues of puerperal tubal sterilization — an update

1995

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This review focuses on the safety, efficacy, pros and cons of tubal sterilization procedures performed during the puerperium period while the woman is still in hospital. Findings from four previous reviews are synthesized, and the results published in more recent literature are evaluated. The review finds that tubal sterilization performed while the woman is still on the delivery table, or during a woman's early puerperium while she remains hospitalized, is operationally easy and medically safe, and does not adversely affect lactation. However, reported pregnancy rates are generally higher in puerperal tubal sterilization than in interval sterilization, especially when the mechanical tubal occlusion technique is used. The Pomeroy method, and its modifications via minilaparotomy, is highly recommendable. On the other hand, electrocoagulation via laparoscopy is associated with high efficacy, but a potentially increased risk of complications and difficulties in tubal reversal. Tubal sterilizations can be easily and safely performed at cesarean delivery in selected cases. Tubal sterilization performed during puerperium has a number of advantages over short-acting contraceptive methods, which require strict compliance, for postpartum use. However, candidates for puerperal tubal sterilization need to be carefully screened and counseled, since post-sterilization regret is more likely to occur. Unsettled issues for puerperal tubal sterilization and a number of practical problems that need to be addressed before initiation of a puerperal tubal sterilization program in a maternity clinic/hospital are discussed.

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“…For example, Eren, Ramos, and Gray (1983) found in the Philippines that auxiliary nurse-midwives provided better follow-up counseling and services to clients receiving IUDs than did physicians. One of the Thailand studies indicated that nurses provided more information to women about tubal ligation than did doctors (Kanchanasinith et al 1990). Our literature review yielded no reports or articles on task sharing in family planning clinics that reported a negative impact on quality of care.…”

Section: Task Sharing Within Clinics Frees Up Time For Higher-level Hmentioning

confidence: 99%

“…In the 1980s, physicians in Thailand could not adequately meet the demand for female sterilization. Nurse-midwives were trained to perform sterilizations, thereby freeing up the doctors' time to perform higher-level tasks (Satyapan et al 1983;Kanchanasinith et al 1990).…”

mentioning

confidence: 99%