The challenge of obstetrics in a developing country.

For the 13 months between 1 May 1975 and 31 May 1976 a prospective study was made in a maternity wing of a hospital in a developing country. Out of 2196 mothers who gave birth, 278 were classified as requiring special care. The rate of caesarean section showed a steep fall, from 30,76% in 1967 to 2,98% in 1976. The rate for the present series was just over 3%. The series has highlighted the challenges the obstetrician has to meet in a developing country. Patients with pre-eclampsia rank high in the admissions, as do patients with a bad obstetric history, Venereal disease is commonly encountered and requires adequate treatment. Lack of adequate medical services is among the important factors responsible for the obstetric difficulties encountered. Lack of communication and transport facilities aggravates the problems of midwives and obstetricians in developing countries. This study shows how a simple plan and hard work by all concerned can achieve commendable results in spite of the overwhelming inadequacies.