Evaluating midwifery units (EMU): Lessons from the pilot study

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

doi:10.1016/j.midw.2012.08.012

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…If the need for transfer to the referral tertiary-level maternity unit arises, the midwifery group practice midwife often, but not always, transfers with the woman and continues to provide midwifery care in the tertiary unit. 25 The referral tertiary-level maternity units are approximately 15-20 km away from the freestanding midwifery units; and transfer time may take between 15 and 65 min depending on traffic conditions. Intrapartum and postnatal transfers occur via car or ambulance depending on the urgency of the transfer.…”

Section: Methods Settingmentioning

confidence: 99%

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Evaluating Midwifery Units (EMU): a prospective cohort study of freestanding midwifery units in New South Wales, Australia

et al. 2014

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ObjectiveTo compare maternal and neonatal birth outcomes and morbidities associated with the intention to give birth in two freestanding midwifery units and two tertiary-level maternity units in New South Wales, Australia.DesignProspective cohort study.Participants494 women who intended to give birth at freestanding midwifery units and 3157 women who intended to give birth at tertiary-level maternity units. Participants had low risk, singleton pregnancies and were at less than 28+0 weeks gestation at the time of booking.Primary and secondary outcome measuresPrimary outcomes were mode of birth, Apgar score of less than 7 at 5 min and admission to the neonatal intensive care unit or special care nursery. Secondary outcomes were onset of labour, analgesia, blood loss, management of third stage of labour, perineal trauma, transfer, neonatal resuscitation, breastfeeding, gestational age at birth, birth weight, severe morbidity and mortality.ResultsWomen who planned to give birth at a freestanding midwifery unit were significantly more likely to have a spontaneous vaginal birth (AOR 1.57; 95% CI 1.20 to 2.06) and significantly less likely to have a caesarean section (AOR 0.65; 95% CI 0.48 to 0.88). There was no significant difference in the AOR of 5 min Apgar scores, however, babies from the freestanding midwifery unit group were significantly less likely to be admitted to neonatal intensive care or special care nursery (AOR 0.60; 95% CI 0.39 to 0.91). Analysis of secondary outcomes indicated that planning to give birth in a freestanding midwifery unit was associated with similar or reduced odds of intrapartum interventions and similar or improved odds of indicators of neonatal well-being.ConclusionsThe results of this study support the provision of care in freestanding midwifery units as an alternative to tertiary-level maternity units for women with low risk pregnancies at the time of booking.

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Section: Methods Settingmentioning

confidence: 99%

“…Women receive antenatal, intrapartum and postnatal care from a number of models of care, including obstetric and midwifery antenatal clinics, general practitioner-shared care, birth centre and midwifery group practice. 25 …”

Section: Methods Settingmentioning

confidence: 99%

Evaluating Midwifery Units (EMU): a prospective cohort study of freestanding midwifery units in New South Wales, Australia

et al. 2014

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“…This implies that whenever any complications occur, pregnant women are taken to hospital. [ 10 11 12 13 14 15 16 ] The Birthplace in England National Prospective Cohort Study demonstrated that in 2007, two out of three trusts offered women a choice between home birth and delivery at an obstetrical department, but no option to use an FMU. [ 17 ] Another more recent study showed that the number of FMUs in the United Kingdom (about 60) has virtually not changed over time, and these centers provide their services to a relatively small group of women, primarily in rural areas.…”

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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