Outcomes of the first midwife-led birth centre in Italy: 5 Years' experience

被引:9
作者
Morano S. [1 ]
Cerutti F. [1 ]
Mistrangelo E. [1 ]
Pastorino D. [1 ]
Benussi M. [1 ]
Costantini S. [1 ]
Ragni N. [1 ]
机构
[1] Department of Obstetrics and Gynaecology, San Martino Hospital, University of Genova, 16100 Genova, P. 1, I piano - Largo R. Benzi
关键词
Low-risk pregnancy; Midwife-led birth centre; Midwives care unit; Straightforward pregnancy;
D O I
10.1007/s00404-007-0358-9
中图分类号
学科分类号
摘要
Objective: To assess the experience of the first 5 years of the first midwife-led birth centre (MLBC) in Italy. Study design: Data were prospectively collected to analyse the first 5 years' experience of the MLBC. MLBC is located alongside a University hospital maternity unit and it offers care to women with a straightforward pregnancy and midwives take primary professional responsibility for care. Women with maternal diseases, complicated obstetric history, height < 150 cm, maternal age > 45, or multiple pregnancy were excluded. Transfer was request in case of antenatal, intrapartum and postpartum pathological conditions. Results: During the 5-year period (1 January 2001-31 December 2005), 1,438 low-risk women were admitted in labour to the MLBC. Of these, 203 (14.1%) were transferred during labour to consultant care (138 because of pathologies and 65 because of request of epidural analgesia). Among the transfers, the caesarean sections were 87, corresponding to 6.1% (87/1,438) of the total of women admitted to MLBC, while the operative vaginal deliveries were 14, corresponding to 1.0% (14/1,438) of the total of women admitted to MLBC. Among women who gave birth in the MLBC, episiotomy rate was 17.1%. Conclusions: In Italy, in the passed 10 years, the caesarean section rate reached 60%, in some regions. According to our data, the first 5 years of activity of the first MLBC in Italy had been associated with a low rate of medical interventions during labour and birth, with high rates of spontaneous vaginal birth and without signs of complications. We hope that this experience could be taken as a model to improve the quality of maternity care in Italy. © 2007 Springer-Verlag.
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页码:333 / 337
页数:4
相关论文
共 26 条
[1]  
Wagner M., Fish can't see water: The need to humanize birth., Int J Gynaecol Obstet, 75, (2001)
[2]  
National Health Service Maternity Statistics, England 1998-99 to 2000-1, (2002)
[3]  
Johanson R., Newburn M., MacFarlane A., Has medicalisation of childbirth gone to far?, BMJ, 321, pp. 892-895, (2002)
[4]  
Williams F., Florey C., Ogston S., Patel N., Et al., United Kingdom study of intrapartum care for low risk primigravidas: A survey of interventions., J Epidemiol Community Health, 52, pp. 494-500, (1998)
[5]  
Saunders D., Boulton M., Chapple J., Et al., Evaluation of the Edgware Birth Center, (2000)
[6]  
Hundley V., Cruickshank F., Lang G., Glazener C., Midwife managed delivery unit: A randomized controlled comparison with consultant led care., Br Med J, 309, pp. 1400-1404, (1994)
[7]  
Rosser J., Birth centers-the key to modernising the maternity services., Midirs, 3, pp. 22-26, (2001)
[8]  
Rooks J.P., Weatherby N.L., Ernst E.K., Et al., Outcomes of care in birth centers. the National Birth Center Study., N Engl J Med, 321, pp. 1804-1811, (1989)
[9]  
Steward M., McCandlish R., Henderson J., Brocklehurst P., Report of a Structured Review of Birth Centre Outcomes, (2004)
[10]  
Azonobi I., McBride-Richter H., Patrick L., Late-onset postpartum eclampsia., J Midwifery Womens Health, 51, pp. 51-53, (2006)