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A month-long nursing strike led to a reduction in cesarean rate. During a January, 1991 nurses' strike in Manitoba, Canada, hospital obstetric services operated with nursing staff at about 30% of normal. The cesarean section rate in the 16-month interval preceding the strike was 14.6%, dropping to 12.5% during the strike, and then returning to 13.7% after the strike was over. Reductions in cesarean rate occurred mostly among women with breech babies and women with a prior cesarean section. Cesareans for these indications accounted for 33% and 55% of the drop, respectively. In addition, fewer inductions of labor, epidurals, and general anesthesias were performed. Overall, newborn morbidity as measured by neonatal intensive care admissions, 5-minute Apgar scores less than 7, stillbirths, trauma, and readmission to the hospital within 30 days rose slightly. This may or may not be due to other factors than reduced nursing staff.

Between 1975 and 1980, 16,586 sonograms, including repeat scans, were obtained on pregnant women for various obstetric indications. The diagnosis of polyhydramnios was made 78 times by an experienced sonographer as a simple observer judgment of an excess amount of amniotic fluid. In pregnancies thus diagnosed, the fetus was then carefully scanned for anomalies, and repeat scans were done. Major clinical problems encountered are discussed.