Development of regionalized perinatal care.

Regionalized perinatal care was first advocated in Canada 35 years ago. Its development in the United States of America (from 1971), United Kingdom (from 1972) and Australia (from 1978), has been described. In all instances, the efforts and perseverance of visionary individuals were crucial in introducing the concepts to the medical profession, and in bringing the principles to national consciousness at a governmental level. Official endorsement of regionalized perinatal care by both the national professional bodies and the central and regional governments was necessary. An important milestone along the path of regionalized perinatal care was the establishment of national training programmes, and the recognition of maternal-fetal medicine and neonatal-perinatal medicine as respective subspecialties for obstetricians and paediatricians. The developmental process requires close collaboration among all three groups (individuals, professional bodies and government) to improve both the quality and availability of perinatal services to a geographically defined region.