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Changing Obstetric Practices
Changing Established Practices  ,[object Object],[object Object],[object Object],[object Object],Obstetric and Midwifery Practice
Evidence-Based Medicine ,[object Object],Obstetric and Midwifery Practice
So What Has Changed? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Obstetric and Midwifery Practice
Beneficial Forms of Care ,[object Object],[object Object],[object Object],Obstetric and Midwifery Practice
Beneficial Forms of Care (continued) ,[object Object],[object Object],[object Object],[object Object],Obstetric and Midwifery Practice
Active vs. Physiological Management: Postpartum Hemorrhage Obstetric and Midwifery Practice Prendiville et al 1988,  Rogers et al 1998. Active Management Physiologic Management OR and 95% CI Bristol Trial 50/846 (5.9%) 152/849 (17.9%) 3.13 (2.3 – 4.2) Hinchingbrooke Trial 51/748 (6.8%) 126/764 (16.5%) 2.42 (1.78 – 3.3)
Forms of Care of Unknown Effectiveness ,[object Object],[object Object],[object Object],[object Object],Obstetric and Midwifery Practice
Forms of Care Likely to Be Ineffective ,[object Object],[object Object],[object Object],[object Object],Obstetric and Midwifery Practice
Forms of Care Likely to Be Harmful ,[object Object],[object Object],[object Object],[object Object],Obstetric and Midwifery Practice
Antenatal Care Practices ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Obstetric and Midwifery Practice
Essential Care Series Obstetric and Midwifery Practice
Promoting a Culture of Quality Care ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Obstetric and Midwifery Practice
References Obstetric and Midwifery Practice AbouZahr C and T Wardlaw. 2001.  Maternal Mortality in 1995: Estimates Developed by WHO, UNICEF, UNFPA . World Health Organization (WHO): Geneva. Duley L and D Henderson-Smart. 2000. Magnesium sulphate versus diazepam for eclampsia (Cochrane Review), in  The Cochrane Library . Issue 4. Update Software: Oxford.  Maine D. 1999. What's So Special about Maternal Mortality?, in  Safe Motherhood Initiatives: Critical Issues . Berer M et al (eds). Blackwell Science Limited: London.  Prendiville et al. 1988. The Bristol third stage trial: Active versus physiological management of the third stage of labor.  BMJ  297: 1295–1300.
References (continued) Obstetric and Midwifery Practice Rogers J et al. 1998. Active versus expectant management of third stage of labour: The Hinchingbrooke randomised controlled trial.  Lancet  351 (9104): 693–699.  Sadik N. 1997. Reproductive health/family planning and the health of infants, girls and women.  Indian J Pediatr  64(6): 739 – 744.  WHO. 1999.  Care in Normal Birth: A Practical Guide . Report of a Technical Working Group. WHO: Geneva. WHO 1998.  Pospartum Care of the Mother and Newborn: A Practical Guide . Report of a Technical Working Group. WHO: Geneva.

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02 Changing midwifery practices

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  • 7. Active vs. Physiological Management: Postpartum Hemorrhage Obstetric and Midwifery Practice Prendiville et al 1988, Rogers et al 1998. Active Management Physiologic Management OR and 95% CI Bristol Trial 50/846 (5.9%) 152/849 (17.9%) 3.13 (2.3 – 4.2) Hinchingbrooke Trial 51/748 (6.8%) 126/764 (16.5%) 2.42 (1.78 – 3.3)
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  • 12. Essential Care Series Obstetric and Midwifery Practice
  • 13.
  • 14. References Obstetric and Midwifery Practice AbouZahr C and T Wardlaw. 2001. Maternal Mortality in 1995: Estimates Developed by WHO, UNICEF, UNFPA . World Health Organization (WHO): Geneva. Duley L and D Henderson-Smart. 2000. Magnesium sulphate versus diazepam for eclampsia (Cochrane Review), in The Cochrane Library . Issue 4. Update Software: Oxford. Maine D. 1999. What's So Special about Maternal Mortality?, in Safe Motherhood Initiatives: Critical Issues . Berer M et al (eds). Blackwell Science Limited: London. Prendiville et al. 1988. The Bristol third stage trial: Active versus physiological management of the third stage of labor. BMJ 297: 1295–1300.
  • 15. References (continued) Obstetric and Midwifery Practice Rogers J et al. 1998. Active versus expectant management of third stage of labour: The Hinchingbrooke randomised controlled trial. Lancet 351 (9104): 693–699. Sadik N. 1997. Reproductive health/family planning and the health of infants, girls and women. Indian J Pediatr 64(6): 739 – 744. WHO. 1999. Care in Normal Birth: A Practical Guide . Report of a Technical Working Group. WHO: Geneva. WHO 1998. Pospartum Care of the Mother and Newborn: A Practical Guide . Report of a Technical Working Group. WHO: Geneva.