The contribution of the labour ward midwife in the prevention of low Apgar scores - abstract

ABSTRACT

The relationship between the workload of the labour ward midwife and neonatal outcome was retrospectively studied over a 3-year period. The Apgar scores were used as an index of neonatal outcome. The ratio of monthly deliveries to the number of midwives assigned to the labour ward for that month was used as an index of workload. There was a total of 8,066 live-births, with an average monthly delivery rate of 227.6. The average number of midwives assigned to the labour ward per month was 13.6. There were 15 midwives/month in the first year of the study as compared with 12 in the third year. As a result, the workload for each midwife increased from 15 deliveries per month in the first year to 18 in the third year. There were, on average, 14 deliveries per midwife each month between January and June and 20 between July and December. Within any particular month, workloads (X) were positively correlated with the proportion of deliveries with Apgar scores of less than 7 at 1 minute (Y = 0.9003 X 10.2034, p < 0.001), and of less than 4 at 5 minutes (Y = 0.1636 X - 0.9683, p < 0.01). Decreasing numbers of midwives (X) were correlated with increasing percentages of deliveries with an Apgar score of less than 7 at 1 minute (Y = 18.0483 - 0.4773 X p < 0.05). Decreasing numbers of midwives (X) were also correlated with increasing percentages of low birth weight infants with an Apgar score of less than 7 at 5 minutes (Y = 27.4813 - 1.1823 X, p < 0.05). It is suggested (1) that more midwives should be assigned to the labour ward during the July - December period, (2) that the work efficacy of midwives should be improved, and (3) that more midwives should be recruited (AU)