Cluster-randomized Trial Measuring Integration of Professional Midwives and Obstetric Nurses in Rural Clinics in Mexico

Rates and causes of maternal mortality in Mexico have dropped only slightly; thus, reaching the internationally established Millennium Development Milestones (MDM) is still a distant goal. A fundamental part of reducing maternal and infant mortality is ensuring skilled attendance during pregnancy and delivery. This project uses an innovative strategy of integrating professional midwives and licensed obstetric nurses into rural medical centers in the states of Guerrero and Oaxaca, Mexico, to provide prenatal care, delivery services, and puerperium care. The goal of the research is to increase use of best practices in intake, labor, delivery, and puerperium care; decrease the use of unnecessary or harmful care; and improve maternal and neonatal outcomes. We posited that medical centers receiving the intervention would provide better care and have better maternal and neonatal outcomes than those that did not receive the intervention.

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Key information

Conditions

Pregnancy Death Female Urogenital Diseases and Pregnancy Complications Maternal Death Parental Death Pathologic Processes Pathological Conditions, Signs and Symptoms Perinatal Death Pregnancy Complications Urogenital Diseases

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Clinics containing one medical team only (1 doctor and accompanying staff)
Clinics less than 2 hours away from a referral hospital
Clinics where at least 25 deliveries took place in the previous year

Exclusion criteria

Clinics inaccessible by car
Clinics undergoing remodeling

Treatment and study plan

PM/ON integration

Other

Professional midwives or obstetric nurses are integrated into clinic staff and delivering services.

Primary outcomes

Use of evidence-based practices during labor, delivery, and postpartum care

Time frame: 21 months

Will collect data on deliveries ocurring in sites over 21 month period.
volume of prenatal visits, deliveries

Time frame: 21 months

We will Assess overall number of first and follow up prenatal visits and deliveries in intervention and control sites
Use of harmful or unnecessary practices during labor and delivery

Time frame: 21 months

We will assess use of harmful or unnecessary practices during labor and delivery

Sponsors and collaborators

Lead sponsor

Instituto Nacional de Salud Publica, Mexico

Other

Collaborators

Mexican Center for Gender Equity and Reproductive Health
Mexican National Institute for Women
Secretary of Health, Guerrero state
Secretary of Health, Oaxaca state

Registry information

Official study title

Incorporation of Alternative Providers for Care During Pregnancy, Delivery and Postpartum in Rural Public Health Clinics.

Important dates

Study start: 2007
Primary completion: 2010
First posted: Nov 22, 2011
Registry last updated: Nov 22, 2011

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed