| Outcomes of free-standing, midwife-led birth centers: a structured review. | |
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MedLine Citation:
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PMID: 15330886 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Over the last two decades, childbirth worldwide has been increasingly concentrated in large centralized hospitals, with a parallel trend toward more birth interventions. At the same time in several countries, interest in midwife-led care and free-standing birth centers has steadily increased. The objective of this review is to establish the current evidence base for free-standing, midwife-led birth centers. METHODS: A structured review, based on Cochrane guidelines, was conducted that included nonrandomized studies. The comparative outcomes measured were rates of normal vaginal birth; cesarean section; intact perineum; episiotomy; transfers; and babies remaining with their mothers. RESULTS: Of the 5 controlled studies that met the review criteria, all except one was a single site study. Since no study was randomized, meta-analysis was not performed. The included studies all raised quality concerns, and significant heterogeneity was observed among them. For the outcomes measured, every study reported a benefit for women intending to give birth in the free-standing, midwife-led unit. CONCLUSIONS: The benefits shown for women recruited into the included studies who intended to give birth in a free-standing, midwife-led unit suggest a question about the efficacy of consultant unit care for low-risk women. However, the findings cannot be generalized beyond the individual studies. Good quality controlled studies are needed to investigate these issues in the future. |
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Authors:
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Denis Walsh; Soo M Downe |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Birth (Berkeley, Calif.) Volume: 31 ISSN: 0730-7659 ISO Abbreviation: Birth Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-08-27 Completed Date: 2004-12-02 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8302042 Medline TA: Birth Country: United States |
Other Details:
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Languages: eng Pagination: 222-9 Citation Subset: IM |
Affiliation:
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Childbearing and Health (ReaCH) Group, Lancashire, United Kingdom. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Birthing Centers* Delivery, Obstetric / methods Episiotomy / utilization Female Germany / epidemiology Great Britain / epidemiology Humans Infant Mortality Infant, Newborn Midwifery* Patient Transfer / statistics & numerical data Pregnancy United States / epidemiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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