Grand multiparity: benefits of a referral program for hospital delivery and postpartum tubal ligation
Barss, P.; Blackford, C.
Papua and new Guinea Medical Journal 28(1): 35-39
1985
ISSN/ISBN: 0031-1480 PMID: 3862314 Document Number: 248832
The maternal death rate is high in grand multiparas giving birth in remote villages in Milne Bay Province, Papua New Guinea. Such women are often reluctant to go to the hospital for delivery. However, many of them have accepted the idea of going to the hospital to await delivery and postpartum tubal ligation. The results and benefits of this program are discussed. 43% of grand multiparas suffered 1 or more complications during their hospitalization; 77% were sterilized. Considerable morbidity and mortality can be prevented by an active program for hospital management of grand multiparas. Costs of such early referral are at least partially offset by decreasing costs for late emergency transfer of obstetric disasters. 47% of emergency air charters for obstetric complications were for grand multiparas. Numbers of such emergency transfers have decreased as increasing numbers of grand multiparas have been referred early for delivery and tubal ligation.