Cover Image
close this book12. Referral in Pregnancy and Childbirth: Concepts and Strategies
close this folderThe Crucial Issues
View the document(introduction...)
View the documentShould Interventions Focus Exclusively on Referral of Emergencies?
View the documentShould Interventions Focus Only on Complications of Pregnancy and Childbirth?
View the documentSelf Referral and Informed Decision Making

Should Interventions Focus Exclusively on Referral of Emergencies?

The importance of access to obstetric emergency care is undisputed (WHO 1996). However, there is also evidence to justify elective referral for maternal and perinatal reasons, as outlined earlier (Villar & Bergsjo 1997). This is also acknowledged by the Safe Motherhood Initiative by stating that a minimum of 15% of all pregnant women should deliver in obstetric referral level facilities (Inter-agency group for safe motherhood 1997). Most of these will not be emergencies. In addition there is often no clear line between emergency and elective referral, as in the case of mild antepartum haemorrhage. It may be sensible to start with a focus on emergency referral. Yet, there is a need to also improve and rationalise referral for all pregnancy-related conditions. This could be done, for instance, through locally adapted and operational referral guidelines and related tools such as referral forms and feedback reports, transport arrangements and special admission routines in the referral centre.