Outcomes of Care in Birth Centers

Rooks, Judith P.; Weatherby, Norman L.; Ernst, Eunice K.M.; Stapleton, Susan R.; Rosen, David R.; Rosenfield, Allan

doi:10.1097/00006254-199008000-00007

Cited by 30 publications

(44 citation statements)

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“…Freestanding birth centres have been studied in different settings, concluding that birth centres are a safe alternative to hospital for low-risk women. 7 It is also shown that general practitioners and midwives can identify a low-risk population that can deliver safely at maternity homes, with a low rate of operative deliveries and transfers. 8 Freestanding, midwife-led birth centres report higher rates of normal births and lower rates of caesarean sections and episiotomies.…”

Section: Introductionmentioning

confidence: 99%

Is the operative delivery rate in low-risk women dependent on the level of birth care? A randomised controlled trial

Bernitz

Rolland

Blix

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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ObjectiveTo investigate possible differences in operative delivery rate among low-risk women, randomised to an alongside midwifery-led unit or to standard obstetric units within the same hospital.DesignRandomised controlled trial.SettingDepartment of Obstetrics and Gynaecology, Østfold Hospital Trust, Tromsø, Norway.PopulationA total of 1111 women assessed to be at low risk at onset of spontaneous labour.MethodsRandomisation into one of three birth units: the special unit; the normal unit; or the midwife-led unit.Main outcome measuresTotal operative delivery rate, augmentation, pain relief, postpartum haemorrhage, sphincter injuries and intrapartum transfer, Apgar score <7 at 5 minutes, metabolic acidosis and transfer to neonatal intensive care unit.ResultsThere were no significant differences in total operative deliveries between the three units: 16.3% in the midwife-led unit; 18.0% in the normal unit; and 18.8% in the special unit. There were no significant differences in postpartum haemorrhage, sphincter injuries or in neonatal outcomes. There were statistically significant differences in augmentation (midwife-led unit versus normal unit RR 0.73, 95% CI 0.59–0.89; midwife-led unit versus special unit RR 0.69, 95% CI 0.56–0.86), in epidural analgesia (midwife-led unit versus normal unit RR 0.68, 95% CI 0.52–0.90; midwife-led unit versus special unit RR 0.64, 95% CI 0.47–0.86) and in acupuncture (midwife-led unit versus normal unit RR 1.45, 95% CI 1.25–1.69; midwife-led unit versus special unit RR 1.45, 95% CI 1.22–1.73).ConclusionsThe level of birth care does not significantly affect the rate of operative deliveries in low-risk women without any expressed preference for level of birth care.

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Section: Introductionmentioning

confidence: 99%

Is the operative delivery rate in low-risk women dependent on the level of birth care? A randomised controlled trial

Bernitz

Rolland

Blix

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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show abstract

“…9 Two other studies in the ABC setting reported that 1% of newborns had Apgar scores < 7 at the fi fth minute after birth, and 93% and 98% of the babies had Apgar scores of 7 to 10 at the fi rst and fi fth minutes after birth, respectively. 6,17 In Brazil, a study showed a reduction in the proportion of babies with Apgar scores < 7 at the fi fth minute (2.1% to 1.1%) after implementation of a ABC (OR = 0.55; 95%CI 0.27;1.14). When interpreting the results of this study, it is important to consider the differences and similarities among the models of assistance and the particular characteristics of each setting.…”

Section: Discussionmentioning

confidence: 99%

Resultados maternos e neonatais em centro de parto normal peri-hospitalar e hospital

Schneck

Riesco²,

Bonadio³

et al. 2012

Rev. Saúde Pública

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OBJECTIVE:To compare maternal and neonatal outcomes in low-risk women assisited in an alongside birth center and at a hospital. METHODS:A cross-sectional study was conducted with a representative sample of low-risk women in São Paulo (Southeastern Brazil), from 2003 to 2006. The study included 991 women who delivered a child at the alongside birth center and 325 who delivered a child at a hospital. Data were obtained from medical records. A comparative analysis was performed for all of the women, who were stratifi ed according to parity. The chi-square test and Fisher's exact test were used to compare outcomes between women who delivered in alongside birth center and those who gave birth in the hospital. RESULTS:There was a homogeneous distribution of women according to parity (45.4% were nulliparous, and 54.6% had one or more previous deliveries). Statistically signifi cant differences were found in the frequency of amniotomy (more frequent in nulliparous women treated at the hospital), the use of oxytocin during labor, and the use of postpartum analgesia (both more frequent among women of any parity treated at the hospital). The rate of episiotomy was higher in nulliparous women, both in the alongside birth center and at the hospital. Neonatal interventions were more frequent at the hospital and included aspiration of the upper airways, gastric aspiration, gastric lavage, and the use of an open oxygen mask. Other events that occurred with greater frequency at the hospital included caput succedaneum, respiratory discomfort, and admittance to the neonatal unit. There was no difference in Apgar scores at the fi fth minute or cases of maternal or perinatal death. CONCLUSIONS:Care at the alongside birth center involved fewer interventions and had maternal and neonatal outcomes similar to those of the hospital setting.

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“…Parts of these tools have been adapted for birth center research ( Jackson, Lang, Dickinson, & Fullerton, 1994 ). The National Birth Center Study ( Rooks et al, 1989 ) and a national Home Birth Study ( Murphy & Fullerton, 1998 ) also developed instruments that attempted to quantify both process and outcomes of care. These tools were developed specifi cally for documentation of midwifery care practices and outcomes and are not widely used by other perinatal clinical practitioners.…”

Section: Measuring Processes Of Care As Well As Outcomesmentioning

confidence: 99%

Development of the Optimality Index as a New Approach to Evaluating Outcomes of Maternity Care

Murphy

Fullerton

2006

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Outcomes of Care in Birth Centers

Cited by 30 publications

References 0 publications

Is the operative delivery rate in low-risk women dependent on the level of birth care? A randomised controlled trial

Is the operative delivery rate in low-risk women dependent on the level of birth care? A randomised controlled trial

Resultados maternos e neonatais em centro de parto normal peri-hospitalar e hospital

Development of the Optimality Index as a New Approach to Evaluating Outcomes of Maternity Care

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