Outcomes in rural obstetrics, Atherton Hospital 1991-2000.

Analysis of annual obstetric audit data collected over the decade 1991-2000 from the Atherton Hospital in Far North Queensland provides ongoing evidence of safe obstetric practice provided by a group of non-specialist doctors in a rural community. During that period, there were 2997 deliveries; of these, 2400 (80.1%) were public patients and 596 (19.9%) were private patients. There were 16 perinatal deaths (perinatal mortality rate 5.3/1000). This is remarkably consistent with the outcome of the previous decade, 1981-90, when the total deliveries was 2883 with 15 perinatal deaths (perinatal mortality rate 5.2/1000). However, compared with 1981-90, the number of Caesarean sections rose from an overall rate of 13.0% (public 10.6%; private 18.3%) to an overall rate of 17.4% (public 16.7%; private 20.4%). In 1981-90, there were 909 private confinements (31.5% of total) and in 1991-2000 there were 597 (19.9% of total). This decline in the number of private obstetric cases may have significant implications for future models of care. There were no maternal deaths in the 20 years 1981-2000.