A comparison of frequency of medical interventions and birth outcomes between the midwife led unit and the obstetric unit in low-risk primiparous women

Anita Prelec,Ivan Verdenik,Angela Poat

doi:10.14528/snr.2014.48.3.16

Anita Prelec, Ivan Verdenik + Show 1 more

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https://doi.org/10.14528/snr.2014.48.3.16

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Abstract

Introduction: The purpose of this national research was to compare birth, maternal and newborn outcomes in the midwife led unit and the obstetric unit to ascertain whether a midwife led unit reduced medicalisation of childbirth. Methods: A prospective observational case-control study was carried out in Ljubljana Maternity Hospital in the period May - August 2013. The sample comprised 497 labouring women; 154 who attended the midwife led and 343 who attended in the obstetric unit, both matching the same inclusion criteria: low risk primiparous; singleton term pregnancies, normal foetal heart beat, cephalic presentation; spontaneous onset of labour. The primary outcome was the caesarean section rate. Chi-square test was used to compare medical interventions and birth outcomes. Results: Women in the midwife led unit had statistically significant higher spontaneous vaginal births (p < 0.001), less augmentation with oxytocin (p < 0.001), less use of analgesia (p < 0.001), less operative vaginal deliveries (p < 0.001) and less caesarean sections (p < 0.001), lower rates of episiotomy (p < 0.001) and more exclusively breastfed (p = 0.002). Discussion and conclusion: These significant findings showed that in the midwife led unit fewer medical interventions were used. For generalisation of the findings more similar studies in Slovenia are needed.

Highlights

The purpose of this national research was to compare birth, maternal and newborn outcomes in the midwife led unit and the obstetric unit to ascertain whether a midwife led unit reduced medicalisation of childbirth
A normal physiological labour and (Overgaard, et al, 2011; Suzuki, et al, 2011), reduced birth is powered by the innate human capacity of the caesarean section and instrumental vaginal births woman and fetus
Supporting the normal physiologic (Janssen, et al, 2007), less use of analgesia and processes of labour and birth has the potential to episiotomy (Eide, et al, 2009), control during labour, enhance best outcomes for the mother and newborn more spontaneous vaginal births and initiating of (American College of Nurse-Midwives, 2013)

Summary

Introduction

The purpose of this national research was to compare birth, maternal and newborn outcomes in the midwife led unit and the obstetric unit to ascertain whether a midwife led unit reduced medicalisation of childbirth. Results: Women in the midwife led unit had statistically significant higher spontaneous vaginal births (p < 0.001), less augmentation with oxytocin (p < 0.001), less use of analgesia (p < 0.001), less operative vaginal deliveries (p < 0.001) and less caesarean sections (p < 0.001), lower rates of episiotomy (p < 0.001) and more exclusively breastfed (p = 0.002). Supporting the normal physiologic (Janssen, et al, 2007), less use of analgesia and processes of labour and birth has the potential to episiotomy (Eide, et al, 2009), control during labour, enhance best outcomes for the mother and newborn more spontaneous vaginal births and initiating of (American College of Nurse-Midwives, 2013).

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