A comparison between midwifery and obstetric care at birth in Spain: Across-sectional study of perinatal outcomes

Background The organizational structure of maternity services determines the choice of which professionals provide care during pregnancy, birth, and the postnatal period, and it influences the kind of care they deliver and the level of continuity of care offered. There is considerable evidence that...

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Autores: Martin Arribas, Anna, Escuriet, Ramon, Borràs-Santos, Alicia, Vila-Candel, Rafael, González-Blázquez, Cristina
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:20.500.14342/5142
Acceso en línea:http://hdl.handle.net/20.500.14342/5142
https://doi.org/10.1016/j.ijnurstu.2021.104129
Access Level:acceso abierto
Palabra clave:Llevadores
Obstetrícia
Part
Perinatologia
Naixement
Estudi transversal
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spelling A comparison between midwifery and obstetric care at birth in Spain: Across-sectional study of perinatal outcomesMartin Arribas, AnnaEscuriet, RamonBorràs-Santos, AliciaVila-Candel, RafaelGonzález-Blázquez, CristinaLlevadoresObstetríciaPartPerinatologiaNaixementEstudi transversalBackground The organizational structure of maternity services determines the choice of which professionals provide care during pregnancy, birth, and the postnatal period, and it influences the kind of care they deliver and the level of continuity of care offered. There is considerable evidence that demonstrates a relationship between how care is provided and the maternal and neonatal health outcomes. Registered midwives and obstetricians provide maternity care across Spain. To date, no studies have assessed whether maternity outcomes differ between these two groups. Objective The aim of this study was to examine the association between the care received (midwifery care versus obstetric care) and the maternal and neonatal outcomes in women with normal, low- and medium-risk pregnancies in Spain from 2016 to 2019. Design A prospective, multicentre, cross-sectional study was carried out as part of COST Action IS1405 at 44 public hospitals in Spain in the years 2016–2019. The protocol can be accessed through the registry ISRCTN14062994. The sample size of this study was 11,537 women. The primary outcome was mode of birth. The secondary outcomes included augmentation with oxytocin, use of epidural analgesia, women's position at birth, perineal integrity, third stage of labour management, maternal and neonatal admission to intensive care, Apgar score, neonatal resuscitation, and early initiation of breastfeeding. Chi-square tests for categorical variables and independent sample t-test for continuous variables to assess differences between the midwifery and obstetric groups were calculated. Odds ratio with intervals of confidence at 95% were calculated for obstetric interventions and perinatal outcomes. A multivariate logistic regression model was applied in order to examine the effect of type of healthcare provider on perinatal outcomes. These models were adjusted for care provider, type of onset of labour, use of anaesthesia, pregnancy risk, maternal age, parity, and gestational age at birth. Results Midwifery care was associated with lower rates of operative births and severe perineal damage and had no higher adverse outcomes. No statistically significant differences were observed in the use of other obstetric interventions between the two groups. Conclusions The findings of this study should encourage a shift in the current maternity care system towards a greater integration of midwifery-led services in order to achieve optimal birth outcomes for women and newborns.info:eu-repo/semantics/publishedVersionElsevierUniversitat Ramon Llull. Facultat de Ciències de la Salut BlanquernaGrup de recerca Global Health, Gender and Society - GHenderS2022info:eu-repo/semantics/article8 p.http://hdl.handle.net/20.500.14342/5142https://doi.org/10.1016/j.ijnurstu.2021.104129reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésInternational journal of nursing studies, 2022, 126: 104129© L'autor/aAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:20.500.14342/51422026-05-29T05:05:01Z
dc.title.none.fl_str_mv A comparison between midwifery and obstetric care at birth in Spain: Across-sectional study of perinatal outcomes
title A comparison between midwifery and obstetric care at birth in Spain: Across-sectional study of perinatal outcomes
spellingShingle A comparison between midwifery and obstetric care at birth in Spain: Across-sectional study of perinatal outcomes
Martin Arribas, Anna
Llevadores
Obstetrícia
Part
Perinatologia
Naixement
Estudi transversal
title_short A comparison between midwifery and obstetric care at birth in Spain: Across-sectional study of perinatal outcomes
title_full A comparison between midwifery and obstetric care at birth in Spain: Across-sectional study of perinatal outcomes
title_fullStr A comparison between midwifery and obstetric care at birth in Spain: Across-sectional study of perinatal outcomes
title_full_unstemmed A comparison between midwifery and obstetric care at birth in Spain: Across-sectional study of perinatal outcomes
title_sort A comparison between midwifery and obstetric care at birth in Spain: Across-sectional study of perinatal outcomes
dc.creator.none.fl_str_mv Martin Arribas, Anna
Escuriet, Ramon
Borràs-Santos, Alicia
Vila-Candel, Rafael
González-Blázquez, Cristina
author Martin Arribas, Anna
author_facet Martin Arribas, Anna
Escuriet, Ramon
Borràs-Santos, Alicia
Vila-Candel, Rafael
González-Blázquez, Cristina
author_role author
author2 Escuriet, Ramon
Borràs-Santos, Alicia
Vila-Candel, Rafael
González-Blázquez, Cristina
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Universitat Ramon Llull. Facultat de Ciències de la Salut Blanquerna
Grup de recerca Global Health, Gender and Society - GHenderS
dc.subject.none.fl_str_mv Llevadores
Obstetrícia
Part
Perinatologia
Naixement
Estudi transversal
topic Llevadores
Obstetrícia
Part
Perinatologia
Naixement
Estudi transversal
description Background The organizational structure of maternity services determines the choice of which professionals provide care during pregnancy, birth, and the postnatal period, and it influences the kind of care they deliver and the level of continuity of care offered. There is considerable evidence that demonstrates a relationship between how care is provided and the maternal and neonatal health outcomes. Registered midwives and obstetricians provide maternity care across Spain. To date, no studies have assessed whether maternity outcomes differ between these two groups. Objective The aim of this study was to examine the association between the care received (midwifery care versus obstetric care) and the maternal and neonatal outcomes in women with normal, low- and medium-risk pregnancies in Spain from 2016 to 2019. Design A prospective, multicentre, cross-sectional study was carried out as part of COST Action IS1405 at 44 public hospitals in Spain in the years 2016–2019. The protocol can be accessed through the registry ISRCTN14062994. The sample size of this study was 11,537 women. The primary outcome was mode of birth. The secondary outcomes included augmentation with oxytocin, use of epidural analgesia, women's position at birth, perineal integrity, third stage of labour management, maternal and neonatal admission to intensive care, Apgar score, neonatal resuscitation, and early initiation of breastfeeding. Chi-square tests for categorical variables and independent sample t-test for continuous variables to assess differences between the midwifery and obstetric groups were calculated. Odds ratio with intervals of confidence at 95% were calculated for obstetric interventions and perinatal outcomes. A multivariate logistic regression model was applied in order to examine the effect of type of healthcare provider on perinatal outcomes. These models were adjusted for care provider, type of onset of labour, use of anaesthesia, pregnancy risk, maternal age, parity, and gestational age at birth. Results Midwifery care was associated with lower rates of operative births and severe perineal damage and had no higher adverse outcomes. No statistically significant differences were observed in the use of other obstetric interventions between the two groups. Conclusions The findings of this study should encourage a shift in the current maternity care system towards a greater integration of midwifery-led services in order to achieve optimal birth outcomes for women and newborns.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.14342/5142
https://doi.org/10.1016/j.ijnurstu.2021.104129
url http://hdl.handle.net/20.500.14342/5142
https://doi.org/10.1016/j.ijnurstu.2021.104129
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv International journal of nursing studies, 2022, 126: 104129
dc.rights.none.fl_str_mv © L'autor/a
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv © L'autor/a
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 8 p.
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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