Skip header and navigation

Refine By

5 records – page 1 of 1.

Child births in a modified midwife managed unit: selection and transfer according to intended place of delivery.

https://arctichealth.org/en/permalink/ahliterature58675
Source
Acta Obstet Gynecol Scand. 2001 Mar;80(3):206-12
Publication Type
Article
Date
Mar-2001
Author
J. Holt
I N Vold
B. Backe
M V Johansen
P. Oian
Author Affiliation
Department of Pediatrics, Nordland Central Hospital, Bodø, Norway.
Source
Acta Obstet Gynecol Scand. 2001 Mar;80(3):206-12
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Adult
Birthing Centers - organization & administration - utilization
Delivery Rooms - utilization
Delivery, Obstetric - classification
Female
Hospitals, Rural
Humans
Midwifery
Norway
Obstetrics and Gynecology Department, Hospital - organization & administration - standards
Outcome Assessment (Health Care)
Patient Selection
Patient transfer
Perinatal Care - organization & administration
Pregnancy
Pregnancy outcome
Prospective Studies
Research Support, Non-U.S. Gov't
Abstract
BACKGROUND: As small obstetrical departments may not be able to give second-level perinatal care, the delivery unit at Lofoten hospital was for the years 1997-98 reorganized to a modified midwife managed unit. Women at low obstetrical risk were delivered at this unit and women at high risk were referred to the central hospital. We assessed the effectiveness of the risk selection. MATERIAL AND METHODS: The study was a prospective, pragmatic, population-based trial. Desired outcome was defined as a non-operative delivery at 35-42 weeks gestational age giving an infant not needing resuscitation. Intermediate outcomes: Operative deliveries, infants transferred to neonatal intensive care unit and infants diverging from normal. The intended place of delivery was ultimately decided at admittance to the midwife managed unit. RESULTS: Of the 628 women in study 435 (69.3%) gave birth at the midwife managed unit, 152 (24.2%) were selected to be delivered at the central hospital and 41 (6.5%) were transferred to the central hospital after admittance to the midwife managed unit. Desired outcome was recorded in 94% of the deliveries at the midwife managed unit as compared to 50.3% at the central hospital. Women who intended to be delivered at the midwife managed unit, needed fewer operative deliveries and relatively few infants were transferred to the neonatal intensive care unit or diverged from normal. CONCLUSIONS: As nearly 70% of the births occurred at the midwife managed unit and 94% of these deliveries had a desired outcome, this indicates an effective selection process. This model might be an alternative to centralization of births in sparsely population areas.
PubMed ID
11207485 View in PubMed
Less detail

Interest in alternative birthplaces among women in Ottawa-Carleton.

https://arctichealth.org/en/permalink/ahliterature229174
Source
CMAJ. 1990 May 1;142(9):963-9
Publication Type
Article
Date
May-1-1990
Author
B. Soderstrom
P J Stewart
C. Kaitell
M. Chamberlain
Author Affiliation
Ottawa-Carleton Health Department.
Source
CMAJ. 1990 May 1;142(9):963-9
Date
May-1-1990
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Canada
Choice Behavior
Delivery Rooms - utilization
Female
Home Childbirth - utilization
Humans
Operating Rooms - utilization
Patient Acceptance of Health Care
Pregnancy
Questionnaires
Socioeconomic Factors
Statistics as Topic
Abstract
Birthing rooms, birth centres and home birth have been proposed as alternatives to the traditional in-hospital caserooms to meet the needs of women and their families more effectively. We performed a descriptive survey to determine the level of interest of childbearing women in the Ottawa-Carleton region in these birthplaces and to examine the characteristics of women who express an interest in using them. Of the 1629 women who gave birth between July 1 and Aug. 28, 1987, 1115 (68.4%) completed a self-administered questionnaire during the pregnancy, in the early postpartum period in hospital or at home. Of the respondents 577 (53.1%) said they would choose the caseroom, 316 (29.1%) the birthing room, 165 (15.2%) the birth centre and 30 (2.8%) home birth. The women who expressed an interest in a birthplace other than the caseroom were more likely than the others to be older, married, well-educated and interested in midwifery services and to breastfeed their babies (p less than 0.05). They were also more likely to have had a low-intervention vaginal birth (p less than 0.05). The interest expressed in birthing rooms, birth centres and home birth suggests that these alternatives should be considered for inclusion in the health care system.
Notes
Cites: J Fam Pract. 1979 Sep;9(3):407-14479772
Cites: Am J Obstet Gynecol. 1980 Jun 1;137(3):377-847377258
Cites: Dimens Health Serv. 1981 Jun;58(6):26-8, 30-17239040
Cites: CMAJ. 1986 Aug 15;135(4):285-83730994
Cites: CMAJ. 1988 Oct 15;139(8):773-43167739
Cites: Can Nurse. 1977 Nov;73(11):31-4922714
Comment In: CMAJ. 1990 Oct 15;143(8):707-92207928
PubMed ID
2328467 View in PubMed
Less detail

Satisfaction with a modified form of in-hospital birth center care compared with standard maternity care.

https://arctichealth.org/en/permalink/ahliterature117607
Source
Birth. 2012 Jun;39(2):106-14
Publication Type
Article
Date
Jun-2012
Author
Charlotta Tingstig
Karin Gottvall
Charlotta Grunewald
Ulla Waldenström
Author Affiliation
Midwife at the, South General Hospital (Södersjukhuset, Södra BB).
Source
Birth. 2012 Jun;39(2):106-14
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adult
Birthing Centers - utilization
Confidence Intervals
Delivery Rooms - utilization
Female
Humans
Infant, Newborn
Odds Ratio
Patient Satisfaction - statistics & numerical data
Postnatal Care - utilization
Pregnancy
Prenatal Care - utilization
Questionnaires
Sweden - epidemiology
Women's health
Young Adult
Abstract
For safety reasons an in-hospital birth center was replaced by a modified form of birth center care with the same medical guidelines and equipment as in standard care. The aim of this study was to investigate women's and men's satisfaction with modified care compared with standard care.
Women in both groups gave birth from July 2007 to July 2008. The same medical low-risk criteria during pregnancy applied to both groups. Of those invited to the study, 547 (82.7%) women in modified birth center care and 445 (66.7%) men returned a questionnaire posted 2 months after the birth, and 786 (71.6%) women and 639 (58.2%) men in standard care. Odds ratios (ORs) for being satisfied were calculated with 95 percent confidence intervals (CIs) and adjusted for possible confounders. We also explored the effects of different components of care on overall satisfaction.
Adjusted ORs for being satisfied overall were approximately doubled in the modified birth center group compared with the standard care group: antenatal care-OR: 2.1 (95% CI: 1.6-2.7) in women and OR: 2.2 (95% CI: 1.5-2.8) in men; intrapartum care-OR: 2.2 (95% CI: 1.7-2.9) in women and OR: 1.7 (95% CI: 1.3-2.4) in men; and postpartum care-OR: 1.7 in women (95% CI: 1.4-2.2) and OR: 2.1 (95% CI: 1.6-2.8) in men. Important explanations of these differences included perception of the midwife as being more supportive, the presence of a calmer environment and atmosphere (intrapartum), and the option for fathers to stay overnight (postpartum).
In-hospital birth center with medical equipment on site increased overall satisfaction with all episodes of care compared with standard care. (BIRTH 39:2 June 2012).
PubMed ID
23281858 View in PubMed
Less detail

Swedish women's interest in home birth and in-hospital birth center care.

https://arctichealth.org/en/permalink/ahliterature63564
Source
Birth. 2003 Mar;30(1):11-22
Publication Type
Article
Date
Mar-2003
Author
Ingegerd Hildingsson
Ulla Waldenström
Ingela Rådestad
Author Affiliation
Department of Caring and Public Health Sciences, Mälardalen University, Västerås, Sweden.
Source
Birth. 2003 Mar;30(1):11-22
Date
Mar-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cohort Studies
Delivery Rooms - utilization
Delivery, Obstetric - nursing - psychology - utilization
Female
Home Childbirth - utilization
Humans
Logistic Models
Middle Aged
Midwifery
Patient Satisfaction - statistics & numerical data
Pregnancy
Prevalence
Questionnaires
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Abstract
BACKGROUND: In Sweden, few alternatives to a hospital birth are available, and little is known about consumer interest in alternative birth care. The aim of this study was to determine women's interest in home birth and in-hospital birth center care in Sweden, and to describe the characteristics of these women. METHODS: All Swedish-speaking women booked for antenatal care during 3 weeks during 1 year were invited to participate in the study. Three questionnaires, completed after the first booking visit in early pregnancy, at 2 months, and 1 year after the birth, asked about the women's interest in two alternative birth options and a wide range of possible explanatory variables. RESULTS: Consent to participate in the study was given by 3283 women (71% of all women eligible). The rates of response to the three questionnaires were 94, 88, and 88 percent, respectively. One percent of participants consistently expressed an interest in home birth on all three occasions, and 8 percent expressed an interest in birth center care. A regression analysis showed five factors that were associated with an interest in home birth: a wish to have the baby's siblings (OR 20.2; 95% CI 6.2-66.5) and a female friend (OR 15.2; 95% CI 6.2-37.4) present at the birth, not wanting pharmacological pain relief during labor and birth (OR 4.7; 95% CI 1.4-15.3), low level of education (OR 4.5; 95% CI 1.8-11.4), and dissatisfaction with medical aspects of intrapartum care (OR 3.6; 95% CI 1.4-9.2). An interest in birth center care was associated with experience of being in control during labor and birth (OR 8.3; 95% CI 3.2-21.6), not wanting pharmacological pain relief (OR 2.3; 95% CI 1.3-4.1), and a preference to have a known midwife at the birth (OR 2.2; 95% CI 1.6-2.9). CONCLUSION: If Swedish women were offered free choice of place of birth, the home birth rate would be 10 times higher, and the 20 largest hospitals would need to have a birth center. Women interested in alternative models of care view childbirth as a social and natural event, and their needs should be considered.
PubMed ID
12581035 View in PubMed
Less detail