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Hi Vanora
 
Not much help from this side of the water but Maternity services in Southern Ireland are going through a change process but I am not sure anyone knows where the change will take us.  The North Eastern Health Board is a geographically large and with a relatively low population density and they had a review of their maternity services culminating in the commonly titled Kinder Report which you may be interested in.
 
It's official title is 'Report of the Maternity Services Review Group ' and it can be downloaded from http://www.nehb.ie/nehb/ and clicking on the appropriate link
 
On another note, I did not get your original mail to the list and only spotted it in Sally's reply...interesting
 
Best of luck
 
Regards

Declan Devane,
Doctoral Student / Midwifery Research Assistant,
School of Nursing and Midwifery Studies,
University of Dublin Trinity College,
Trinity Centre for Health Sciences Education,
St. James's Hospital,
Dublin 8.
Tel: 087 659 6923
Email: [log in to unmask]

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-----Original Message-----
From: A forum for discussion on midwifery and reproductive health research. [mailto:[log in to unmask]]On Behalf Of Sally Marchant
Sent: 24 November 2002 22:08
To: [log in to unmask]
Subject: Re: rural maternity care

Not thought through but I have links with midwives in Finland who face similar geographic aspects to Scotland as do most of the Scandinavian countries. Also have links with Denmark although this is less recent.   My personal filing system is in chaos at present as I have only just regained my 'library' from over a year in storage and I can't find a thing. If you are interested in exploring this please get back to me - just one comment, in Helsinki one of the things they were doing was encouraging the whole family to come to the central maternity hospital for the birth and immeditealy afterwards - the antithesis of what you are exploring but the background to this might be of interest...let me know
----- Original Message -----
From: [log in to unmask]>Vanora Hundley
To: [log in to unmask]>[log in to unmask]
Sent: Wednesday, November 20, 2002 2:20 PM
Subject: rural maternity care

RURAL MATERNITY CARE

At the University of Aberdeen (Scotland) a small team of us (three research midwives, a health service researcher, an educationalist and a management studies person, and a sociologist) are about to start a research project on the organization of rural maternity care in Scotland. We are keen to hear from people elsewhere in the world about how they have dealt with the following four problems:
(1)     distance to specialist care in an emergency;
(2)     small populations in sparsely populated areas;
(3)     cost of service provision per head of population or per child born;
(4)     the maintenance of midwifery and medical skills. 
The same way one can not have an opera house, a library, a bank and a lawyer in every small village and hamlet, one can not have a small hospital or midwife or doctor in parts of the country where too few births occur.  How can we offer the best maternity care in rural areas?

Any reference to reports, publications, of good practice or simply of papers outlining the problems etc. will be very welcome.

Many thanks.

Please contact Edwin van Teijlingen or Vanora Hundley either by email:
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Or at:
Department of Public Health
University of Aberdeen
Aberdeen  AB24 2ZD
Scotland   UK
Tel.:  00-44-1224-552495