The rise and decline of Victorian Rural Obstetrics: What we can learn.

The rural stillbirth rate of 17.1 per one thousand births was 59% of the State average of 29.7 per thousand , and the neonatal death rate pf 14.9 per thousand was 50% of the State average of 30.1 per thousand.6 As a consequence, by 1932 the VBNA had gained the full support of the medical and nursing professions. [...] Essential to this is familiarity with the birthing process, the personnel to be involved in the birth, and place of confinement. [...] Professor Roger Pepperell, commenting on the ‘extraordinarily high standards……equal to the best institutions in the world’ of Bush Nursing Hospitals (BNHs), opined in 1983 that he could not see the perinatal mortality rate (still 25% of the State average in 1998), bettered by teaching hospitals.9 Professor Michael Quinn in 1991 described the obstetric data as ‘unparalleled…. [...] How much was this just a facet of the BNH system? By the 1980s the model probably had extended to the whole of ‘small rural’ Victoria. [...] The greater the distance, the greater the consequences.