The experience of one obstetrician in a rural area in emergency obstetrics

Abstract

Chiangrai, a northern province of Thailand has continued to find challenges in providing emergency obstetric care similar to other rural areas in developing countries. However, several intervention campaigns aiming to prevent and minimize emergency obstetrics-related problems were carried out successfully in the local community during 1974 to 2003. These campaigns included: (1) birth reduction campaign with a decreased birth rate from 3.2% to 1.0% between 1974-2003, (2) HIV vertical transmission rate reduction campaign resulted in a decrease from 42% in 1994 to 5.75% in 2003, (3) perinatal morbidity and mortality reduction campaign through establishing supervision committees and setting up standard guidelines for proper treatment and, (4) a campaign to eliminate violence and sex abuse of women and girls through setting up 'One Stop Crisis Center'. One of the key successes behind the campaigns' positive outcome was likely to result from a high level of coordination and collaboration among specialists, non-specialists and local volunteers. Limitations in the number of obstetricians and related facilities will continue in rural areas. Therefore, alliances among multi-disciplinary teams are viewed as a vital necessity for emergency obstetric care in rural areas.