Freestanding midwifery units: Maternal and neonatal outcomes following transfer

Monk, Amy; Grigg, Celia; Foureur, Maralyn; Tracy, Mark; Tracy, Sally

doi:10.1016/j.midw.2017.01.006

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…International literature supports the safety of an out‐of‐hospital birth in a low‐risk population in systems in which an out‐of‐hospital birth is well integrated in a broader maternal‐child health program 2, 3, 4, 5, 6, 7, 8, 9, 10, 11. The safety of a planned home birth under midwifery care in Ontario has been established 12, 13.…”

Section: Introductionmentioning

confidence: 99%

“…1 International literature supports the safety of an out-ofhospital birth in a low-risk population in systems in which an out-of-hospital birth is well integrated in a broader maternalchild health program. [2][3][4][5][6][7][8][9][10][11] The safety of a planned home birth under midwifery care in Ontario has been established. 12,13 Although a stand-alone birth center already existed in Ontario as part of Six Nations Health Services (where Aboriginal midwives care for women), the 2 new birth centers marked the first instance in which midwifery care by registered midwives has been systematically provided in a new setting since regulation of the profession in 1994.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes for the First Year of Ontario's Birth Center Demonstration Project

Ae¹,

Sidney²,

Ek³

et al. 2018

J Midwife Womens Health

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IntroductionIn 2014, Ontario opened 2 stand‐alone midwifery‐led birth centers. Using mixed methods, we evaluated the first year of operations for quality and safety, client experience, and integration into the maternity care community. This article reports on our study of safety and quality of care.MethodsThis descriptive evaluation focused on women admitted to a birth center at the beginning of labor. For context, we matched this cohort (on a 1:4 basis) with similar low‐risk midwifery clients giving birth in a hospital. Data sources included Ontario's Better Outcomes Registry and Network (BORN) Information System, the Canadian Institute for Health Information, Ontario census data, and birth center records.ResultsOf 495 women admitted to a birth center, 87.9% experienced a spontaneous vaginal birth, regardless of the eventual location of birth, and 7.7% had a cesarean birth. The transport rate to a hospital was 26.3%. When compared with midwifery clients with a planned hospital birth, rates of intervention (epidural analgesia, labor augmentation, assisted vaginal birth, and cesarean birth) were significantly lower in the planned birth center group, even when controlled for previous cesarean birth and body mass index. Markers of potential morbidity were identified in about 10% of birth center births; however, there were no short‐term health impacts up to discharge from midwifery care at 6 weeks postpartum. Care was low in intervention and safe (minimal negative outcomes and transport rates comparable to the literature).DiscussionIn the first year of operation, care was consistent with national guidelines, and morbidity and mortality rates and intervention rates were low for women with low‐risk pregnancies seeking a low‐intervention approach for labor and birth. Further evaluation to confirm these findings is required as the number of births grows.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcomes for the First Year of Ontario's Birth Center Demonstration Project

Ae¹,

Sidney²,

Ek³

et al. 2018

J Midwife Womens Health

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“…Considering the outcome of birth among pregnant women in the CPDCF who were transfered to the hospital, it was found that the cesarean section prevalence was higher (37.5%) when compared to international studies on the results of assistance in birth centers, that went from 12.1% to 23.1% (6,15,19) . This finding may indicate an influence of the high proportion of surgical childbirths in Brazilian obstetrics (20) .…”

Section: Discussionmentioning

confidence: 86%

Adequação da assistência pré-natal em casa de parto e causas associadas com as transferências hospitalares

Oliveira

Pereira

Penna

et al. 2019

Rev. Gaúcha Enferm.

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Resumo OBJETIVO Analisar a adequação da assistência pré-natal em Casa de Parto e as causas associadas com as transferências maternas e dos recém-nascidos para o hospital. MÉTODOS Estudo transversal dos atendimentos da única Casa de Parto, de 2009 a 2014, no Rio de Janeiro. As análises estatísticas foram pelo Teste χ2 e Razão de Prevalência (RP). RESULTADO A assistência pré-natal adequada predominou (42,8%) e não houve associação (p=0,55) com as transferências. A transferência materna é causada pela bolsa amniótica rota (RP= 2,09; IC 95% 1,62-2,70) e batimentos cardíacos fetais alterados (RP= 3,06; IC 95% 2,13-4,39). As transferências do recém-nascido estão associadas com a presença de mecônio no líquido amniótico (RP= 2,40; IC 95% 1,30 - 4,43); Apgar abaixo de 7 (RP= 5,33; IC 95% 2,65-10,73) e assistência ventilatória ao nascer (RP= 9,41; IC 95% 5,52-16,04). CONCLUSÃO As intercorrências na assistência intraparto são as causas associadas com as transferências.

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“…demonstrated that the proportion of women who have been transferred from FMUs and delivered by cesarean was lower than in the case of those giving birth at a tertiary obstetrical center. [ 37 ] According to Rowe et al ., median transfer time, defined as the time elapsed between the decision to transfer and initial evaluation at an obstetrical department was shorter in the case of women delivering at home than in those giving birth at an FMU. [ 38 ]…”

Section: Resultsmentioning

confidence: 99%

Freestanding midwife-led units: A narrative review

Bączek

Tataj‐Puzyna

Sys

et al. 2020

Iranian J Nursing Midwifery Res

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Background: Strengthening of midwives' position and support for freestanding birth centers, frequently referred to as Freestanding Midwife-led Units (FMUs), raise hopes for a return to humanized labor. Our study aimed to review published evidence regarding FMUs to systematize the knowledge of their functioning and to identify potential gaps in this matter. Materials and Methods: A structured integrative review of theoretical papers and empirical studies was conducted. The literature search included MEDLINE, Cochrane, Scopus, and Embase databases. The analysis included papers published in 1977–2017. Relevant documents were identified using various combinations of search terms and standard Boolean operators. The search included titles, abstracts, and keywords. Additional records were found through a manual search of reference lists from extracted papers. Results: Overall, 56 out of 107 originally found articles were identified as eligible for the review. Based on the critical analysis of published data, six groups of research problems were identified and discussed, namely, 1) specifics of FMUs, 2) costs of perinatal care at FMUs, 3) FMUs as a place for midwife education, 4) FMUs from midwives' perspective, 5) perinatal, maternal, and neonatal outcomes, and 6) FMUs from the perspective of a pregnant woman. Conclusions: FMUs offers a home-like environment and complex midwifery support for women with uncomplicated pregnancies. Although emergency equipment is available as needed, FMU birth is considered a natural spontaneous process. Midwives' supervision over low-risk labors may provide many benefits, primarily related to lower medicalization and fewer medical interventions than in a hospital setting.

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Freestanding midwifery units: Maternal and neonatal outcomes following transfer

Cited by 8 publications

References 12 publications

Outcomes for the First Year of Ontario's Birth Center Demonstration Project

Outcomes for the First Year of Ontario's Birth Center Demonstration Project

Adequação da assistência pré-natal em casa de parto e causas associadas com as transferências hospitalares

Freestanding midwife-led units: A narrative review

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