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The Norwegian Board of Health in the counties carried out countrywide supervision of 26 of the 60 maternity units in the country’s five health authorities. The investigation looked at whether the health trusts, through systematic management and continuous improvements, ensure that maternity units are organized in such a way that they meet the requirements for sound professional standards. Four main areas were investigated:

  • selection of women to different types of maternity unit
  • monitoring and follow-up of a selection of conditions
  • dealing with acute emergencies
  • learning and improvement

Although Norway is one of the safest countries in which to give birth, supervision of the services has shown that there is room for improvement. Both in relation to selection of women to the most appropriate level of care, and monitoring and follow-up during delivery, areas have been identified in which improvements can be made. Reliable national figures on the incidence of different conditions and the results of maternity services are not available. Not all the health trusts have organized their services in such a way as to ensure that necessary communication and cooperation between physicians and midwives take place, and allocation of responsibility is not clearly defined in all places. Leadership and management can also be improved.

It is recommended that a national data set should be developed, based on data that shall be registered in all the maternity units. This data set can be used both for internal quality improvement and to provide a country-wide overview. Attempts should be made to reduce the incidence of some birth complications. The health trusts must develop appropriate arenas for the development of cooperation. Unclear lines of management should be clarified. The administrators must also ensure that results are used for systematic evaluation, improvement and management of the units.