Obstetric Care in Norway - A Collaborative and Knowledge-building project

Birth care in Norway - a competence-building collaborative project anchored at the Norwegian Institute of Public Health. There is little knowledge about how accessibility to different types of maternity facilities and the place of birth influences birth outcomes in mothers and children in high-income countries. We have previously shown a significant decline in the number of maternity facilities in Norway over many decades, with increasing travel time for mothers to the nearest facility, and increasing geographical inequality in birth outcomes associated with poorer accessibility. Our new project has the main goal of contributing new and better knowledge about the risk of serious illness and death for the woman and fetus/newborn in connection with childbirth and how access to different types of maternity facilities and the place of birth affects this, with a particular focus on vulnerable groups such as immigrant women and women living in rural areas. The project is carried out in collaboration with obstetricians from the women's clinics in Stavanger, Bergen and Drammen and with the Norwegian Association of Midwives and the National Center for Women's Health Research. The Norwegian Gynecological Association and the Norwegian Women's Sanitary Association are user representatives. Together with our partners, we aim to develop new and better measures for serious complications in women during pregnancy and childbirth using registry data and course analyses that will be tested for the course of treatment in women who experience serious complications. Serious infections in pregnant women and women in labor are one of the serious complications that are focused on, and after the COVID-19 pandemic from 2020, COVID-19 disease in pregnant women/women in labor is included among these. We will also map outcomes for the fetus and newborn. An important goal is also to study how travel time between the mother's home and the nearest birth facility, as well as the type of birth facility, influences the risk of serious complications for the mother and child. The calculation of travel time is based on individual geographical data, which is unique in our study. International comparisons will provide further knowledge about how the health service can prevent serious birth complications. The results will help to uncover barriers that prevent the right treatment at the right time and to implement measures that can reduce social inequality in health.