Are outcomes compromised when mothers are assigned to birth centers for care?

Scupholme, Anne; Kamons, A.Susan

doi:10.1016/0091-2182(87)90112-1

Cited by 18 publications

(65 citation statements)

References 3 publications

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“…The most common study design was a matched cohort comparison. Eleven of the reviewed articles compared a cohort of women planning or beginning labor in the birth center with a similar group of women in the hospital . Six articles (4 from analyzing a single dataset) reported cohort studies of freestanding birth center care that did not employ a matched comparison group .…”

Section: Resultsmentioning

confidence: 99%

“…Six articles (4 from analyzing a single dataset) reported cohort studies of freestanding birth center care that did not employ a matched comparison group . Cohort studies used a prospective design in 13 articles based on 7 datasets . There were 5 retrospective cohort studies .…”

Section: Resultsmentioning

confidence: 99%

“…Women who are transferred after this initial intrapartum assessment but prior to admission (known as a preadmit intrapartum transfer in 2 studies), are included in the intrapartum transfer data of some but not all studies, affecting the ability to compare rates across studies. Twelve articles reported intrapartum transfer rates as a ratio of women transferred following admission in labor to all women admitted . Four articles calculated intrapartum transfer rates from a denominator of women planning birth center birth at the beginning of labor .…”

Section: Resultsmentioning

confidence: 99%

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Maternal Outcomes in Birth Centers: An Integrative Review of the Literature

Alliman¹,

Phillippi²

2016

J Midwife Womens Health

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Introduction:The birth center, a relatively recent innovation in maternity care, is an increasingly popular location of birth. The purpose of this integrative literature review is to assess the research on maternal outcomes from birth center care. Methods:Using methods by Whittemore and Knafl, we conducted an integrative review of studies of birth centers published in English since 1980. Twenty-three quantitative sources and 9 qualitative sources describing maternal outcomes of birth center care were reviewed and synthesized.Results: Outcomes for women receiving birth care were positive. Spontaneous vaginal birth rates and perineal integrity were higher for women beginning care in a birth center compared to women in hospital care. Rates of cesarean birth were also lower for women planning birth center care. Transfer rates are difficult to compare across studies, but antepartum transfer rates ranged from 13% to 27.2%. Intrapartum transfer rates ranged from 11.6% to 37.4%, and from 11.6% to 16.5% in studies published from 2011 to 2013. Nulliparous women had higher rates of transfer than multiparous women. Few severe maternal outcomes and no maternal deaths were reported in any studies. Women were satisfied with the comprehensive, personalized care that they received from birth centers.Discussion: Quantitative studies reviewed included more than 84,300 women. The heterogeneity of the studies and variations of practice limit generalization of findings. However, even with multisite studies enrolling a variety of birth centers and practice changes over time, the consistency of positive outcomes supports this model of care. Policy makers in the United States should consider supporting the birth center model as a means of improving maternal outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Maternal Outcomes in Birth Centers: An Integrative Review of the Literature

Alliman¹,

Phillippi²

2016

J Midwife Womens Health

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“…A matched cohort study conducted in the 1980s attempted to address the issue of self- selection bias for freestanding midwifery units by comparing two cohorts of women, one self-selected and the other assigned to midwifery unit care (Scupholme and Kamons, 1987). No differences in outcome were detected, supporting the argument that self-selection is not the primary influence on outcomes of care in midwifery unit settings.…”

Section: Discussionmentioning

confidence: 99%

Survey of women׳s experiences of care in a new freestanding midwifery unit in an inner city area of London, England: 2. Specific aspects of care

2014

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Objectiveto describe and compare women׳s experiences of specific aspects of maternity care before and after the opening of the Barkantine Birth Centre, a new freestanding midwifery unit in an inner city area.Designtelephone surveys undertaken in late pregnancy and about six weeks after birth. Two separate waves of interviews were conducted, Phase 1 before the birth centre opened and Phase 2 after it had opened.SettingTower Hamlets, a deprived inner city borough in east London, 2007–2010.Participants620 women who were resident in Tower Hamlets and who satisfied the Barts and the London Trust’s eligibility criteria for using the birth centre. Of these, 259 women were recruited to Phase 1 and 361 to Phase 2.Measurements and findingsthe replies women gave show marked differences between the model of care in the birth centre and that at the obstetric unit at the Royal London Hospital with respect to experiences of care and specific practices. Women who initially booked for birth centre care were more likely to attend antenatal classes and find them useful and were less likely to be induced. Women who started labour care at the birth centre in spontaneous labour were more likely to use non-pharmacological methods of pain relief, most notably water and less likely to use pethidine than women who started care at the hospital. They were more likely to be able to move around in labour and less likely to have their membranes ruptured or have continuous CTG. They were more likely to be told to push spontaneously when they needed to rather than under directed pushing and more likely to report that they had been able to choose their position for birth and deliver in places other than the bed, in contrast to the situation at the hospital. The majority of women who had a spontaneous onset of labour delivered vaginally, with 28.6 per cent of women at the birth centre but no one at the hospital delivering in water. Primiparous women who delivered at the birth centre were less likely to have an episiotomy. Most women who delivered at the birth centre reported that they had chosen whether or not to have a physiological third stage, whereas a worrying proportion at the hospital reported that they had not had a choice. A higher proportion of women at the birth centre reported skin to skin contact with their baby in the first two hours after birth.Key conclusions and implications for practicesignificant differences were reported between the hospital and the birth centre in practices and information given to the women, with lower rates of intervention, more choice and significant differences in women’s experiences. This case study of a single inner-city freestanding midwifery unit, linked to the Birthplace in England Research Programme, indicates that this model of care also leads to greater choice and a better experience for women who opted for it.

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“…Oversikten inkluderte fire studier fra England (22,(25)(26)(27) (se tab III). Siden oversikten ble bestilt for bruk i den engelske sammenheng, fokuserte oversikten primaert på studier fra England, men den beskrev også syv studier fra USA, Tyskland og Norge (1,20,23,24,(28)(29)(30). Søket ble kjørt i February 2004 og så etter studier fra 1966 fremover.…”

Section: Walsh and Downe 2004unclassified

Fødestuer – fra nyvinning til nedleggelse

Backe¹

2018

Tidsskriftet

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Om rapporten: I dag har opptil en firedel av fødeavdelingene i Norge faerre enn 400 fødsler i året. Ifølge Statens helsetilsyns definisjon skal en fødeavdeling ha minimum 400-500 fødsler i året. Dersom denne definisjonen fremdeles skal gjelde, vil mange fødeavdelinger måtte omdefineres til jordmorstyrte fødestu-er. Dette har møtt betydelig lokal motstand. Problemstilling: Kunnskapssenteret ble bedt om å gjøre en uavhengig gjennomgang av kunnskapsgrunnlaget om effekten av jordmorstyrte fødestuer på mor og barn og gi en oversikt over norsk praksis på området. Om metoden: Det ble søkt etter systematiske oversikter, HTA-rapporter over kontrollerte studier, kohortstudier, tidsseriestudier og kontrollerte før-og etter-studier i definerte databaser fram til desember 2005. Resultater: Fire systematiske oversikter ble inkludert etter kvalitetsvurdering. Alle oversiktene var av moderat til mangelfull metodisk kvalitet. Ingen oversikter omfattet randomiserte kontrollerte studier av effekten av jordmorstyrte fødestuer. Kunnskapsgrunnlaget er derfor basert på resultater fra observasjonsstudier (kohorter og pasientserier). Mange av enkeltstudiene inn- Jordmorstyrte fødestuer Rapport fra Kunnskapssenteret Nr 16-2006 Kunnskapsoppsummering(fortsetter på baksiden) går i flere av oversiktene. GRADE-systemet for vurdering av evidens viste at evidensen var av veldig lav kvalitet i forhold til de viktigste utfallene (dødelighet hos mor og barn, morbiditet hos mor og barn, overflytting av fødende ved jordmorstyrte fødestuer til vanlig fødeavdeling, normale føds-ler, keisersnitt og pasienttilfredshet). Konklusjon: Det er ikke mulig å si noe sikkert om effekten av jordmorstyrte fødestuer (gitt adekvat seleksjon) på kliniske utfall hos mor og barn, sammenliknet med vanlig fødeavdeling. Dette er i tråd med konklusjonen fra de inkluderte oversiktene. Kunnskapsgrunnlaget er i dag for svakt til å konkludere om det er forskjeller i utfall og komplikasjoner mellom fødestuene (med dagens seleksjonspraksis) og fødeavdelingene. Nasjonalt kunnskapssenter for helsetjenesten Oslo, juni 2006 ForordVåren 2005 fikk Nasjonalt kunnskapssenter for helsetjenesten i oppdrag fra Helse Nord RHF å gjøre en kunnskapsoppsummering av effekten av jordmorstyrte fødestuer hos kvinner med lav risiko for fødselskomplikasjoner. Mandatet var som følger:• Foreta en uavhengig gjennomgang av kunnskapsgrunnlaget på effekter av jordmorstyrte fødestuer (gitt adekvat seleksjon) hos mor og barn.• Gi en oversikt over norsk praksis i forhold til dette emnet.Rapporten er en oppsummering av systematiske oversikter. En systematisk oversikt er en oversiktsartikkel der forfatterne har brukt en systematisk og eksplisitt framgangsmåte for å innhente, vurdere og sammenstille resultatene fra enkeltstudier. Vi har lett etter systematiske oversikter både over randomiserte kontrollerte studier, kohortstudier, tidsseriestudier og kontrollerte før-og etterstudier.

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Are outcomes compromised when mothers are assigned to birth centers for care?

Cited by 18 publications

References 3 publications

Maternal Outcomes in Birth Centers: An Integrative Review of the Literature

Maternal Outcomes in Birth Centers: An Integrative Review of the Literature

Survey of women׳s experiences of care in a new freestanding midwifery unit in an inner city area of London, England: 2. Specific aspects of care

Fødestuer – fra nyvinning til nedleggelse

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