Midwives’ contribution to normal childbirth care. Cross-sectional study in public health Settings. MidconBirth Study protocol

Abstract

European Journal of Midwifery of low risk women in spontaneous labour 4 . It has been demonstrated that many common obstetric practices such as rupture of membranes for induction of labour, routine intrapartum amniotomy, continuous electronic foetal heart-rate monitoring or routine continuous infusion of intravenous fluids and oxytocin augmentation, are of limited benefit [5][6] . The range of and variation in the use of interventions in healthy low-risk women who are cared for in highly-technological birth environments have implications both in economic and health terms [7][8][9][10][11][12] . ABSTRACTThis paper presents the Protocol for a multicentre study that seeks to analyse the relationship between midwife care during childbirth and spontaneous vaginal birth. Each participating hospital collects outcome data from a sample of all women birthing, determined according to the number of annual births attended by midwives, in each hospital.Data collected are sociodemographic variables (age, nationality, level of education). Clinical variables collected are onset of labour, augmentation of labour, professional (midwife or obstetrician) providing care in the first and second stage of labour, transfer of care between professionals, mobility during labour, pharmacological and non-pharmacological pain-management methods used, if any, position for birth, mode of birth outcomes, Apgar score at 1 and 5 minutes, birth weight, timing of breastfeeding initiation and breastfeeding rates. The Bologna Score scale items, are evaluated also.The midwife's contribution in the care of normal birth, and the relationship with spontaneous birth (i.e. vaginal birth without the use of instruments) will serve as a basis for further improving the quality of care provided to pregnant women and their families. Phase I of the study ended in January 2017.

Relation between Epidural Analgesia and severe perineal laceration in childbearing women in Catalonia

“…Many studies have shown EA use during labor causes prolonged second stage (Rognant et al, 2012;.Borello-France et al, 2006,), which usually culminates in an instrumental birth with an episiotomy on many occasions [a risk factor of SPL on its own (Carolli et al, 2014;Escuriet et al, 2017]). Therefore, EA contributes to the causal chain of events leading to SPL (Lothian J., 2014).…”

“…We conducted a multicentre prospective study of women giving birth a live infant in 30 maternity hospitals in Catalonia from July 2016 and July 2017. Data for this study were obtained from MBC study database (Escuriet, 2017).…”

“…The main outcome variable in this study was severe perineal laceration (SPL), involving the anal sphincter (third and fourth degree), according to the standardized Royal College of Obstetricians and Gynaecologists obstetric laceration classification (RCOG, 2015). Due to the low incidence of SPL, and that the evidence shows that episiotomy can lead to SPL (Escuriet R., 2017) it was decided to separate the results of the variables "perineum results" in three different categories:…”

“…In 2012, an evaluation of the strategy showed no significant improvement in the quality of care provided and this generated a series of questions about intrapartum care provision which the MidconBirth (MCB) study aims to answer. MCB´s goal is to analyse the relationship between midwife care provision during normal birth and a series of outcomes, including type of birth, type of onset of labor, use of different methods of pain relief during labour and perineal results after childbirth (Escuriet et al, 2017). We decided to conduct a new line of research to analyse the high rate of EA use in Catalonia, Spain ad its relationship to SPL.…”

Transfers of Care between Healthcare Professionals in Obstetric Units of Different Sizes across Spain and in a Hospital in Ireland: The MidconBirth Study

“…The size of maternity units also vary as does the degree of midwifery autonomy [ 6 ]. The most common model in European countries is that of providing care in conventional obstetrics units [ 9 ]. This translates into a situation in which most healthy women receive care in highly technological settings.…”