Comparison of obstetric outcome of a primary-care access clinic staffed by certified nurse-midwives and a private practice group of obstetricians in the same community

Blanchette, Howard

doi:10.1016/0002-9378(95)91424-2

Cited by 37 publications

(44 citation statements)

References 8 publications

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“…the strongest evidence-based support of the optimal rate of episiotomy that can be identified at present relies on studies that report well maternal and neonatal outcomes with very low rates of episiotomy of ten or less per 100 vaginal deliveries (4,5). on that basis, even though the "right" rate of episiotomy is unknown, it is appropriate to conclude that the episiotomy rate of 45 per 100 vaginal deliveries in this study is far higher than is supported by scientific evidence.…”

Section: Discussionmentioning

confidence: 38%

“…on the other hand, studies carried out over the last 20 years show that common indications for episiotomy were based on limited data (1-6). additionally, there was a general underestimation of potential adverse consequences associated with the procedure, including extension to a third or fourth degree tear, unsatisfactory anatomical results, increased blood loss, anal sphincter dysfunction, perineal pain and painful sex (1)(2)(3)(4)(5)(6). records suggest that women who have an episiotomy do not have significantly improved labour, delivery, and recovery compared with those who do not have one (3-5).…”

Section: Introductionmentioning

confidence: 93%

“…By the 1970s, episiotomy rates were as high as 80% in various parts of the world (1-3). although rates of episiotomy in parts of the world have decreased in recent years, it is still one of the most commonly performed procedures in obstetrics (1)(2)(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

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Factors Influencing The Use Of Episiotomy During Vaginal Delivery In South Eastern Nigeria

Chigbu¹,

Onwere²,

Aluka³

et al. 2008

E Af Med Jrnl

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Background: Given considerable evidence that routine episiotomy increases maternal morbidity and without evidence to support maternal or neonatal benefit, has episiotomy use changed among health care providers? To date, very limited information exists relating to the past and current practice of episiotomy in many developing countries. Results: There were 1877 episiotomies, for an episiotomy rate of 45%. Ninety per cent of the primigravid parturients had episiotomy. Women undergoing episiotomy were younger (mean age 24.7 years; range 16-37) than women without episiotomy (mean age 28.5 years, range 20-43). When controlled for parity and maternal age, other risk factors were occipito-posterior position, vacuum extraction, forceps delivery, vaginal breech delivery, and a history of Caesarean section. Episiotomy use was also associated with major perineal lacerations and increased length of hospital stay. Conclusion: The episiotomy rate of 45 per 100 vaginal deliveries in this study is obviously higher than evidence-based recommendations for optimal patient care. A policy of systematic reduction in the incidence of episiotomy can be pursued in this hospital. Greater attention needs to be paid to selection of women to undergo episiotomy.

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Section: Discussionmentioning

confidence: 38%

Section: Introductionmentioning

confidence: 93%

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Factors Influencing The Use Of Episiotomy During Vaginal Delivery In South Eastern Nigeria

Chigbu¹,

Onwere²,

Aluka³

et al. 2008

E Af Med Jrnl

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“…intervenções, e os resultados finais são melhores do que os produzidos pela assistência médica convencional (10)(11) .…”

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Atenção qualificada ao parto: a equipe de enfermagem em Rio Branco, Acre, Brasil

Dotto

Mamede

2008

Rev. esc. enferm. USP

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RESUMENEste estudio tuvo como objetivo identificar y caracterizar a los profesionales de enfermería que atienden el parto, en las maternidades del municipio de Rio Branco-AC. Fue realizado en las dos maternidades del Municipio. La población estudiada estuvo compuesta por 30 profesionales de enfermería. Los datos fueron recolectados por medio de entrevistas. Los resultados mostraron que, de los 25 (83,3%) profesionales de enfermería que atienden el parto normal, 18 (72%) recibieron capacitación a través de educación informal, esto es, acompañando y siendo acompañados por otro profesional durante la jornada de trabajo. Se concluye que, según los criterios de la Organización Mundial de la Salud, apenas siete (28%) profesionales de enfermería, que prestan asistencia a la parturienta, son considerados calificados para esta atención, revelando que existe necesidad de calificación de gran parte del equipo que atiende a las mujeres y sus recién nacidos durante el parto y nacimiento, en las instituciones de salud de Rio Branco. DESCRIPTORES ABSTRACTThis study aimed at identifying and characterizing nursing care professionals assisting childbirth at maternity hospitals in the city of Rio Branco, State of Acre. It was conducted at the city's two maternity hospitals (one philanthropic institution and one public). The studied population con-sisted of 30 nursing professionals. The data were collected by means of interviews. The results showed that of the 25 (83.3%) nursing professionals who performed natural childbirth, 18 (72%) had been given training to perform childbirth through informal education, that is, by following or being followed by another professional during their work. It was concluded that, according to the World Health Organization criteria, only 7 (28%) nursing professionals giving care to parturient women at Rio Branco's institutions may be considered to be qualified for such care giving practice, thus showing that there is a need to qualify most of the nursing staff assisting women in labor and giving birth and their newborns. receberam treinamento por meio de educação informal, isto é, acompanhando e sendo acompanhados por outro profissional durante a jornada de trabalho. Conclui-se que, segundo critérios da Organização Mundial de Saúde, apenas sete (28%) profissionais de enfermagem, que prestam assistência à parturiente, são considerados qualificados para este atendimento, revelando que existe necessidade de qualificação de grande parte da equipe que atende as mulheres e seus recém-nascidos durante o parto e nascimento, nas instituições de saúde de Rio Branco. KEY WORDS

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“…The nurse-midwifery care model offers fewer interventions, improved patient satisfaction, and superior morbidity and mortality rates (Blanchette, 1995;Ernst, 1996;Gabay & Wolfe, 1997;Kennedy, Shannon, Chuahorm, & Kravetz, 2004;MacDorman & Singh, 1998;Oakley et al, 1996). Ulrich (2004) noted that providers following the midwifery model of care ''used technology judiciously and focused on the psychosocial, spiritual, and cultural aspects of birth '' (p. 390).…”

Section: Introductionmentioning

confidence: 99%

The Experience of Perinatal Care at a Birthing Center: A Qualitative Pilot Study

Pewitt¹

2008

jpe

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The purpose of this qualitative descriptive pilot study was to describe women's experiences of care and satisfaction at a freestanding birth center. Data were collected through semistructured interviews with seven women who had given birth within 12 months of participant selection. Using qualitative content analysis, three themes emerged: (1) Empowerment, (2) Sense of Motherhood, and (3) Establishing and Strengthening Relationships. Data revealed that women value caring providers, that caring providers may affect positive outcomes, and that those outcomes may lead to a satisfactory experience.

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Comparison of obstetric outcome of a primary-care access clinic staffed by certified nurse-midwives and a private practice group of obstetricians in the same community

Cited by 37 publications

References 8 publications

Factors Influencing The Use Of Episiotomy During Vaginal Delivery In South Eastern Nigeria

Factors Influencing The Use Of Episiotomy During Vaginal Delivery In South Eastern Nigeria

Atenção qualificada ao parto: a equipe de enfermagem em Rio Branco, Acre, Brasil

The Experience of Perinatal Care at a Birthing Center: A Qualitative Pilot Study

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