Obstetric practice in Finland, 1950-1980. Changes in technology and its relation to health.

The purposes of the paper are to describe changes in the technologic methods used in Finnish obstetric practice and to relate them to some measures of infant and mother health. Antenatal care in Finland still largely retains its original low-technology character, but changes toward more technology-oriented care can be seen. The management of labor and deliveries changed dramatically in the latter half of the 1960s and in the 1970s. More and more births occurred in large, specialized hospitals instead of in small, local hospitals. Electronic fetal monitoring, drug treatment of labor (oxytocin and analgesia), deliveries with instruments, and cesarean sections became common. Comparisons of perinatal mortality by county and by hospital suggest that the correlations between the technologic methods studied, especially cesarean sections, and decreasing perinatal mortality probably do not reflect direct causal relationships.