Midwife managed delivery unit: A randomised controlled comparison with consultant led care

Authors: Hundley, V.A., Cruickshank, F.M., Lang, G.D., Glazener, C.M.A., Milne, J.M., Turner, M., Blyth, D., Mollison, J. and Donaldson, C.

Journal: BMJ

Volume: 309

Issue: 6966

Pages: 1400

eISSN: 1468-5833

ISSN: 0959-8138

DOI: 10.1136/bmj.309.6966.1400

Abstract:

Objective: To examine whether intrapartum care and delivery of low risk women in a midwife managed delivery unit differs from that in a consultant led labour ward. Design: Pragmatic randomised controlled trial. Subjects were randomised in a 2:1 ratio between the midwives unit and the labour ward. Setting: Aberdeen Maternity Hospital, Grampian. Subjects—2844 low risk women, as defined by existing booking criteria for general practitioner units in Grampian. 1900 women were randomised to the midwives unit and 944 to the labour ward. Main outcome measures: Maternal and perinatal morbidity. Results: Of the women randomised to the midwives unit, 647 (34%) were transferred to the labour ward antepartum, 303 (16%) were transferred intrapartum, and 80 (4%) were lost to follow up. 870 women (46%) were delivered in the midwives unit. Primigravid women (255/596, 43%) were significantly more likely to be transferred intrapartum than multigravid women (48/577, 8%). Significant differences between the midwives unit and labour ward were found in monitoring, fetal distress, analgesia, mobility, and use of episiotomy. There were no significant differences in mode of delivery or fetal outcome. Conclusions: Midwife managed intrapartum care for low risk women results in more mobility and less intervention with no increase in neonatal morbidity. However, the high rate of transfer shows that antenatal criteria are unable to determine who will remain at low risk throughout pregnancy and labour. © 1994, BMJ Publishing Group Ltd. All rights reserved.

http://eprints.bournemouth.ac.uk/20562/

Source: Scopus

Midwife managed delivery unit: a randomised controlled comparison with consultant led care.

Authors: Hundley, V.A., Cruickshank, F.M., Lang, G.D., Glazener, C.M., Milne, J.M., Turner, M., Blyth, D., Mollison, J. and Donaldson, C.

Journal: BMJ

Volume: 309

Issue: 6966

Pages: 1400-1404

ISSN: 0959-8138

DOI: 10.1136/bmj.309.6966.1400

Abstract:

OBJECTIVE: To examine whether intrapartum care and delivery of low risk women in a midwife managed delivery unit differs from that in a consultant led labour ward. DESIGN: Pragmatic randomised controlled trial. Subjects were randomised in a 2:1 ratio between the midwives unit and the labour ward. SETTING: Aberdeen Maternity Hospital, Grampian. SUBJECTS: 2844 low risk women, as defined by existing booking criteria for general practitioner units in Grampian. 1900 women were randomised to the midwives unit and 944 to the labour ward. MAIN OUTCOME MEASURES: Maternal and perinatal morbidity. RESULTS: Of the women randomised to the midwives unit, 647 (34%) were transferred to the labour ward antepartum, 303 (16%) were transferred intrapartum, and 80 (4%) were lost to follow up. 870 women (46%) were delivered in the midwives unit. Primigravid women (255/596, 43%) were significantly more likely to be transferred intrapartum than multi-gravid women (48/577, 8%). Significant differences between the midwives unit and labour ward were found in monitoring, fetal distress, analgesia, mobility, and use of episiotomy. There were no significant differences in mode of delivery or fetal outcome. CONCLUSIONS: Midwife managed intrapartum care for low risk women results in more mobility and less intervention with no increase in neonatal morbidity. However, the high rate of transfer shows that antenatal criteria are unable to determine who will remain at low risk throughout pregnancy and labour.

http://eprints.bournemouth.ac.uk/20562/

Source: PubMed

MIDWIFE MANAGED DELIVERY UNIT - A RANDOMIZED CONTROLLED COMPARISON WITH CONSULTANT LED CARE

Authors: HUNDLEY, V.A., CRUICKSHANK, F.M., LANG, G.D., GLAZENER, C.M.A., MILNE, J.M., TURNER, M., BLYTH, D., MOLLISON, J. and DONALDSON, C.

Journal: BRITISH MEDICAL JOURNAL

Volume: 309

Issue: 6966

Pages: 1400-1404

ISSN: 0959-8138

DOI: 10.1136/bmj.309.6966.1400

http://eprints.bournemouth.ac.uk/20562/

Source: Web of Science (Lite)

Midwife managed delivery unit: a randomised controlled comparison with consultant led care.

Authors: Hundley, V., Cruickshank, F.M., Lang, G., Glazener, C.M., Milne, J.M., Turner, M., Blyth, D., Mollison, J. and Donaldson, C.

Journal: BMJ : British Medical Journal (Clinical Research edition).)

Volume: 309

Pages: 1400-1404

ISSN: 0959-8138

DOI: 10.1136/bmj.309.6966.1400

Abstract:

Midwife managed intrapartum care for low risk women results in more mobility and less intervention with no increase in neonatal morbidity. However, the high rate of transfer shows that antenatal criteria are unable to determine who will remain at low risk throughout pregnancy and labour.

http://eprints.bournemouth.ac.uk/20562/

Source: Manual

Preferred by: Vanora Hundley

Midwife managed delivery unit: a randomised controlled comparison with consultant led care.

Authors: Hundley, V.A., Cruickshank, F.M., Lang, G.D., Glazener, C.M., Milne, J.M., Turner, M., Blyth, D., Mollison, J. and Donaldson, C.

Journal: BMJ (Clinical research ed.)

Volume: 309

Issue: 6966

Pages: 1400-1404

eISSN: 1756-1833

ISSN: 0959-8138

DOI: 10.1136/bmj.309.6966.1400

Abstract:

Objective

To examine whether intrapartum care and delivery of low risk women in a midwife managed delivery unit differs from that in a consultant led labour ward.

Design

Pragmatic randomised controlled trial. Subjects were randomised in a 2:1 ratio between the midwives unit and the labour ward.

Setting

Aberdeen Maternity Hospital, Grampian.

Subjects

2844 low risk women, as defined by existing booking criteria for general practitioner units in Grampian. 1900 women were randomised to the midwives unit and 944 to the labour ward.

Main outcome measures

Maternal and perinatal morbidity.

Results

Of the women randomised to the midwives unit, 647 (34%) were transferred to the labour ward antepartum, 303 (16%) were transferred intrapartum, and 80 (4%) were lost to follow up. 870 women (46%) were delivered in the midwives unit. Primigravid women (255/596, 43%) were significantly more likely to be transferred intrapartum than multi-gravid women (48/577, 8%). Significant differences between the midwives unit and labour ward were found in monitoring, fetal distress, analgesia, mobility, and use of episiotomy. There were no significant differences in mode of delivery or fetal outcome.

Conclusions

Midwife managed intrapartum care for low risk women results in more mobility and less intervention with no increase in neonatal morbidity. However, the high rate of transfer shows that antenatal criteria are unable to determine who will remain at low risk throughout pregnancy and labour.

http://eprints.bournemouth.ac.uk/20562/

Source: Europe PubMed Central

Midwife managed delivery unit: a randomised controlled comparison with consultant led care - the cost data

Authors: Hundley, V. and Donaldson, C.

http://eprints.bournemouth.ac.uk/20562/

http://www.abdn.ac.uk/heru/uploads/files/Briefing%20Paper%203.pdf

Source: BURO EPrints