Legislative exchange

of less than 5 were given either alcohol or terbutaline. All patients were placed on broadspectrum antibiotic prophylaxis, even those with intact membranes. Dexamethasone (12 mg IM every 12 hours, two times) was given whenever it was anticipated that delivery could be delayed at least 24 hours. Classical cesarean section was recommended for all fetuses in other than vertex presentations. Ultimately, efforts were made to inhibit labor in 58 women. Of the 26 cesarean sections performed, 7 were in the lower uterine segment and 19 were in the upper segment. The authors now rec-

ommend the classical section, since the survival rate for viable infants in the classical group was 95%, whereas in the lower segment group it was only 43% (p < 0.05). The authors surmise that the classical incision provides a less traumatic delivey, and thereby decreases the incidence of intraventricular hemorrhage in these fragile infants. Infants born to mothers receiving antibiotics had a survival rate of 83%, while those not receiving antibiotics had a survival rate of only 47% (p < 0.03). Of the 18 infants receiving the entire steroid protocol, 17 survived (94%) and of those developing respirato y distress

syndrome (RDS), the survival rate was higher for those delivered by classical cesarean section (91%) as compared with those who had been delivered vaginally (33%). In their discussion the authors admit that the ultimate solution is the prevention of labor, yet they are unable to obtain results significantly better than that ascribed to bedrest alone. The major goal then becomes delivery of the tiny premature in optimum condition, and they suggest application of this protocol, using routine steroids and antibiotics as well as liberal delive y by classical cesarean section.

The American College of Obstetricians and Gynecologists has decided that its visibility and federal lobbying potential will be increased if it moves its national headquarters from Chicago to Washington D.C. The Executive Offices will move to Washington to join ACOGs already established political office of six persons. The move will not take place until after Spring 1980. NAACOG will also move its Executive Office along with ACOG. The move to Washington seems to be in tune with ACOGs intent to mount a public relations campaign to improve its image among consumers, as announced by Dr. Martin Stone, the President of ACOG, at his installation speech in April 1979.

“The Federal Monitor” is a useful and current publication for CNMs interested in following legislative and regulatory activities relating to the health of women and children. It is published at least eight times a year in Washington, D.C., by Maternal and Child Health Legislative Alert, Inc. Membership for a year costs $8.00 (make check payable to MCHLA). Ann Gray, Editor, welcomes articles and information; her address is “The Federal Monitor,” Drawer Q, McLean, Virginia 22101 or call (703) 82143733.

finally publish rules and regulations regarding CNM practice in September. However, the regulations did not appear in either the September or October N.J. Public Register. No explanation was given by the Board. Proposed regulations were first published in April 1978, but withdrawn by the Board after the N.J. midwives were able to mount an effective letter-writing campaign during the public comment period. The N.J. Board of Medical Examiners has also introduced companion legislation into the N.J. Assembly to license nurse-midwives and to outlaw lay midwifey in the state. Nurse-midwives have not been the only target of N.J. Board of Medical Examiners action recently. The Board sought to suspend the licenses of three MDs at the Rutgers Com-

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The saga of the New Jersey midwives continues. The N.J. Council was informed in August 1979 that the Board of Medical Examiners would Journal of Nurse-Midwifery

34 Copyxight @ 1980 by the American College

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of Nurse-MMwives

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Vol. 25, No. 1, January/February

1980